Corona is frightening – here’s how to avoid freaking out

Yeah, I can’t lie, I’ve been stressed about Corona too. As I type this on Saturday morning, 103,739 people have the disease and 3,522 have died. By the time you read this, sadly, both of those numbers will have increased.

Corona is obviously having major ramifications on the world economy, and economists have noted that the potential for this disease to harm our wallets is extremely high. The federal government isn’t exactly doing a bang-up job of instilling confidence in their ability to fight back against this disease, with the President and his staff regularly boasting that the disease is contained when we know that just isn’t true.

An objective look at the facts makes it very likely that the disease is only going to get worse. And, if you have a mental illness, this is likely enough to cause no shortage of panic or anxiety. I had a regularly scheduled appointment with my therapist the other day and asked him if Corona was coming up more often in sessions; he said yes, absolutely.

I certainly can’t blame anyone for being stressed about a potential worldwide pandemic. It is frightening, and even more so if you have a health condition that may make you more prone to becoming ill. That being said, I think that it is important that we keep the coronavirus in perspective and avoid treating it like a death sentence. There are some things we can do to maintain our mental health during this outbreak. Here’s a look.

Focus on what you CAN do

Anxiety – at least to me – is largely about control. I always feel most anxious in situations where I am somehow powerless or helpless, and I know that this is a relatively common theme. Corona is so frightening precisely because it seems as if you have so little control.

Look, that’s not exactly true. There are some things – many things – you can do right now. As noted by governmental officials, you should be:

  • Practice good hygiene. Wash your hands for 2 minutes and multiple times a day, avoid touching your face.
  • Don’t travel to areas with noted outbreaks.
  • Stock up on your emergency kits in the event that there is a disruption of day to day activities.
  • Make plans for you and your family or work in the event that someone gets sick.
  • Research the Coronavirus for symptoms. They appear to be flu-like symptoms.
  • Only get your news from reputable sources. Read something on Twitter? Don’t believe it unless you can confirm it.

And once you do that: Stop. You’re okay. If you are doing everything you can to prevent Corona…well, good! You got this.

Recognize that anxiety has a use

This Lifehacker article on the subject absolutely nails it: Anxiety serves an evolutionary purpose. Yes, anxiety disorders are clearly not helpful, but remember, the purpose of anxiety is to keep you on your toes for any perceived threat. A bit of anxiety over a global pandemic is not a bad thing! It helps ensure that you are keeping informed of developments about the virus and that you don’t take this disorder too lightly.

When you’re feeling anxious, don’t try to suppress it. Try to logic your way through it. Ask yourself:

  • What is the threat? Is there any immediate threat?
  • Are you doing what you can to prevent and prepare for Corona?
  • What do the authorities recommend that you do right now?
  • Do you have an emergency plan?

If you’ve answered these questions satisfactorily, then you’re probably more prepared than the vast majority of society to deal with Corona. Congrats!

Limit your news intake

Throw CNN and Foxnews out the window.

Okay, don’t do that. But remember, the purpose of many news stations isn’t just to keep you informed. It’s to panic you so you need to constantly be turning the news on. These guys profit off of your fear, and yes, they have their use, but don’t sit there, staring at CNN, waiting for the next BREAKING NEWS ALERT (“Wolf Blitzer is coughing, what does this mean!?!?!”). Watch the news at regular intervals, certainly. Stay informed. But at some point, turn the damn TV off.

Of course, there are more tips, and I’d love to hear whatever your recommendations are for staying calm during a viral outbreak. Any tips you want to share with us? Leave them in the comments below!

 

Landmines and Ballerinas: How to cope with a lack of sleep when you’ve got mental health issues

For a lot of reasons, I slept like hell last night. For me, that’s dangerous. To be clear, all of us need a good amount of sleep in order to function the next day – I need at least five hours, I’d say, to be able to fire on all cylinders.

However, and this goes without saying, there is a huge connection between mental health and sleep. A lack of sleep can hurt your mental health, and mental health challenges can hurt your ability to get sleep. I know that both of these items are true for me, and I also know that on nights where I barely sleep (like three hours or less), I can barely function. As I said to my wife today, it feels like my head is filled with landmines and ballerinas that are blowing up those landmines. I absolutely cannot think straight. Of course, that may make this blog entry kind of interesting, so if I write out CHEEEEEEESE or something with no context, just bear with me.

Anyway. If you are like me, this can be a real challenge. A lack of sleep fires every one of my depression and anxiety genes, and I feel like I lack the coping and logic skills to get those emotions back in the bottle. My head feels like it’s filled with fog and sand.

How do I deal with this? I’m not quite sure yet, to be honest. But, broadly speaking, here are some thoughts.

Treat it as a sick day

Look, when you don’t sleep, you feel like crap, right? Take it for what it is: It’s a sick day. I’m not saying curl up in bed and take the day off from work – that may not be an option – but what I am saying is you should go easy on yourself. It’s not as if you somehow asked for mental health problems or to sleep like crap. Give yourself a break, and don’t hold yourself to the same standards that you may do on an otherwise normal day.

Ask yourself what you can do

One of the more impactful moments of my life came about a year after my son was born and when my wife was pregnant with our daughter. I was much, much heavier – 31 pounds or so, depending on the day. And I was upset. I’d really let myself go. And I was complaining about it to my wife, but the complaints weren’t action-oriented. They were just me bitching. And she said the line to me:

“So, what are you going to do about it?”

I don’t know about you, but on days where I’m struggling for one reason or another, I always feel better when I ask myself that question. Look, everyone has bad days. But if they become a pattern,  you have to ask yourself that question. What are you going to do about it? And that’s a key question, because yeah, things may suck at the moment, but if you can say to yourself, “Yes, I can barely think straight and am probably less coordinated now than I am when I’ve had a few drinks, but what can I do to make sure I take care of myself?”

Nap…but…

According to sleep.org, a nap the next day can potentially be helpful, as it can help ease the impact of having trouble sleeping. However, timing is key: Early to mid-afternoon is best, as this decreases the chances of your naping hurting your ability to sleep later that night.

Ultimately, these are just some broad thoughts, and I’d be really curious to hear yours…particularly considering I’m about to go face first into my keyboard. Any advice would be appreciated!

 

Anxiety and a Rigid Life

I have a sincere question for you, and if you have anxiety issues, I suspect you know why I ask this.

One of the best ways I think I’ve ever summarized anxiety – at least the really bad, crippling kind – was by describing it as a box. You live inside the box. And slowly, as the anxiety ramps up, it gets worse, and the box starts to compress. Little by little, it squeezes you in, trapping you and stopping you from doing things you previously enjoyed. Going out late at night. Living with spontaneity. And then you just find your life stuck inside this box, regimented by routines and a fear of fear that you don’t fully understand but absolutely cannot conquer.

Here’s my question: Is this you? Because it does feel like me.

As I’ve discussed previously, generally speaking, I feel like I live a life in recovery. That’s a bit of a complicated statement because I unquestionably still suffer from a series of anxiety and depression related issues. But I say it because I feel like I can lead a good life and a relatively happy one.

But, there’s no question about it: I lead a life that has been limited by anxiety.

Examples? I can’t stand surprises. I have to know where I’m going and what I’m doing. Open social situations – parties, etc – can be intimidating. Weird thing for a politician to write out, right?

I crave routine. I like to be doing X at this time and doing Y at this time. I’m obsessed with my calendar and my to-do list because they keep me on schedule and knowing what I am doing, something I crave and need.

Do I think I’m living in a box still? No. I don’t. But I do think there are some ceilings in my life. Some things which are limited by my anxiety.

Huh. This has been instructive to write. Might be something I want to bring up in therapy later because it’s not something I want to live with. I’d love to live with a bit more flexibility and spontaneity. I’d love to be able to go out places without…fear.

It’s a defense mechanism for me. A coping skill, one developed by the unfortunate reward your body gives out for avoiding the anxiety caused by anxiety-inducing situations. Repeat this pattern enough times and you have agoraphobia. No, that certainly isn’t me, but it is something I always feel like I have to watch out for because I am a natural homebody. I think this is a big part of why.

All of that being said, if you know what I’m talking about, if this writing strikes a chord with you, please comment below and let me know what you think. Does this sound familiar? How do you deal?

 

Why Words Matter – Even If It’s Not You

 

As some of you may have seen in the news or on my Facebook page, we had quite the day this past Friday. Governor Wolf was in town, holding the first of what will be many mental health roundtables. He announced the kick-off of Reach Out PA: Your Mental Health Matters on Thursday. It’s an overall, comprehensive effort to reform and improve Pennsylvania’s mental health system. It’s fantastic and desperately needed.

At the Governor’s Press Conference on Thursday, the Governor said:

“For those struggling with their mental health, we have one message: your mental health matters and it’s okay to reach out for help. We are stepping up our efforts to ensure every Pennsylvanian can access mental health care and more agencies can respond to the challenges facing Pennsylvanians struggling with their mental health. The act of reaching out for help – or to help – can make a huge difference for someone struggling.”

I opened the roundtable with this:

Obviously, I’ve discussed my depression and anxiety before. I haven’t quite gotten that intimate with how close I came to a suicide attempt, so that was a bit new.

I actually wasn’t even planning on doing that until a few hours before the event, when it hit me: I was going back to the place where I had seriously considered ending my life, standing with the Governor, my Congresswoman, friends, colleagues, and advocates, with the goal of saving lives.

(Random side note: I actually tagged my ex-girlfriend on Facebook for saving my life. We’re certainly on good terms, but I can’t imagine how weird that must have been – she looks at her phone and goes, “Wait, who tagged me? Why did that happen?)

I have to say – on a personal level – how much it meant to share that story. At the table with me was the Governor, my Congresswoman (Susan Wild, who has become a dear, dear friend) and Dr. Rachel Levine (PA Secretary of Health). Dr. Levine is brilliant and one of my favorite cabinet members with the Governor. She’s also a pioneer, serving as one of the highest-ranking transgender government officials in the United States. I cannot imagine how many kids and adults look at her and draw hope from her success and competence.

Congresswoman Wild is an advocate for mental health in and of her own right after she lost her life partner, Kerry Acker, to suicide. And Tom Wolf is truly one of the most recent people I’ve ever met in this job.

To be able to share that story – with those fine people, and everyone else in the room – that was meaningful. It gave meaning to what I had endured.

So, away from myself now. What the Governor has said about mental health, what others in his cabinet have said…it matters deeply. It matters because the Governor is lending his personal credibility and institutional strength to a push for better mental health access.

Public policy, public statements, and stigma are all interwoven. By doing events like this, there are people out there who are recognizing what the Governor is doing. At least some people will be touched by his words, by all of our words. And hopefully, they will be more likely to get the help they need and deserve.

Look, this system needs investment. Massive investment. We need more workers, more funding and less stigma. That all ties together. I hope and pray this was the start of a more comprehensive effort.

But I know that hearing someone as important, well known and well-liked as the Governor say that it is okay to ask for help – that matters. And it should matter if you say it, too.

“People who conquered depression and/or anxiety, what’s the #1 factor that helps you?”

As some of my prior entries have indicated, I’m a big fan of Reddit. If you use it the right way it can be hilarious, inspirational and adorable.

One of the more popular subreddits – and certainly one of my favorites – is AskReddit. In AskReddit, users can post a question to the Reddit community. Some of the questions are serious: “Why can’t you sleep tonight?” Some are hilarious: “You’re being interrogated and so far you’ve held strong. What song do they play on repeat that breaks you?”

And then there’s moments like these:

This was truly interesting. The top responses are largely along the lines of answers you might expect: Sleeping well at night, keep busy, stay away from social media (irony, right?), stop overthinking, etc.

I answered this question (surprise!), but I took my answer in a different direction. Here’s what I said:

I’m gonna spin this one on its head a bit. I think it’s important to address this answer to those of us who haven’t conquered depression or anxiety, and who never will.

Depression for some is a temporary condition as a result of a variety of factors, including social or cultural experiences, genetics, your upbringing or traumatic events. For people like this, time, therapy and/or medication – as well as lifestyle changes – can result in permanently defeating depression, and never seeing it again.

For other individuals – and people like me – it’s a permanent, chronic condition. Personally, I’m lucky – my ups are relatively long and my downs are manageable. For now. But, for people who will never truly rid themselves of depression or anxiety – who will experience it all their lives – it’s important to realize that this may be your world. Some people are cursed with physical disabilities which dramatically alter their lives and the way they experience it. For others, like us, it’s a mental disability.

What’s the #1 factor that helped me? I honestly think that one of them is this knowledge. The idea that I will never, truly be rid of depression. Why has this helped? It takes the pressure off. It makes me realize that I can lead a good life, even if this is always who I’ll be. That the “black dog” – as Churchill called it – will be a constant companion and challenge.

Second: To an extent, I have power over it. No, I don’t think I’ll ever be rid of depression. I don’t think I’ll ever be rid of the sinking feeling in my chest, the tension at the base of my neck, the imposture syndrome, the constant fear of losing everything and everyone I love. But I do have control. If I seize it, there are things I can do. That means self-care – therapy, medication, writing, working out being a type-A personality, etc. I accept that it has ruined other parts of my life, but strove to make me better in a variety of others.

Third: Accepting the positives of depression. It has made me constantly force myself to do something to improve myself, my life or those around me. It has made me tougher. It has given me a perspective and sense of empathy which I could never have imagined. And it has dramatically and positively impacted my career (I’m a State Representative in Pennsylvania, where I work largely on mental health issues – I also write and blog on the topic).

Yeah, leave it to a politician to not answer the question and answer it at the same time………..

My answer was long enough and pretty self-explanatory, but it’s worth noting again: Some people don’t “conquer” depression. They just learn to live with it, how to manage its ups and downs. I think that’s me. Once I accepted that – once I stopped kicking myself for feeling the way I did – it let go a lot of stress.

That being said, I don’t want to make it seem like my answer to the question was somehow crapping on the other ones. Less time on the internet, sleeping right, etc. – those are REALLY GOOD WAYS of beating depression. I just think that, for some of us, the idea of “conquering” depression is a bridge too far, sadly.

But that doesn’t mean it gets to run our life!

 

It’s not your fault: The brain circuits behind rumination, depression & anxiety

A fascinating examination of the brains of people who suffer from anxiety and depression has revealed some really interesting insight about how your brain works, and why its so hard to stop thinking once you get in a negative state.

According to a report on the study from Forbes, an examination of 9,000 brain imaging scans has showed that people who suffer from depression or anxiety show low levels of activity in areas of the brain responsible for “cognitive control,” while showing increased activity the parts of the brain which “process emotional thoughts and feelings.”

In other words: People who suffer from depression/anxiety have a harder time controlling their thoughts and keeping their mind from running away from them.

I mean, realistically speaking, this should surprise absolutely no one. If you suffer from depression or anxiety, you know that it is nearly impossible to control your thoughts or your feelings. But, for those of us who suffer, I would hope you can take a degree of comfort in this study, as it physically explains why your brain simply will not shut off on days where you are in pain: It can’t.

It’s okay. It’s not your fault. It never was. But this is just so interesting to me because it shows the biological mechanisms behind depression and anxiety. And it unquestionably lends credence to the notion that we have to treat depression, anxiety and other mental illness as a physical disease, rather than some separate emotional one.

As I’ve written in the past, there is a strong connection between rumination, depression and anxiety, and this study may help explain why: They are all physically connected.

Of course, this begs the question: What can we do about it? When our brains get “locked in” to this state, how can we alter it?

I mean, there’s the usual stuff: Therapy, medication, meditation, exercise, etc. We know that this stuff works to an extent.

I’m not even sure where to go from here, but I do think this study is absolutely fascinating. It provides a biological explanation that we already knew was out there. It explains why its so hard to stop our brains. I am walking, talking rumination, and I would LOOOOOVE to see what my head looks like when I get into a funk.

Let me wrap this entry up by adding to what I said before. If anything, I would hope that this study provides some perspective and can help get rid of some of the guilt and self-loathing that you may experience when you get into a depressed state. Depression and anxiety are not your fault. They never are and they never will be. And this entry helps to prove it. Your brain is, quite literally, working against you and making it hard for you to break out.

Your weirdest anxiety

The Mighty ran this absolutely fascinating list of 27 of the “weirdest” anxiety triggers which impact members of their community. The list was intriguing, if only for the breadth of seemingly minor things which can negatively impact someone. Examples included:

  • Not knowing where a bathroom is
  • Car headlights
  • The Mailbox
  • Power Outlets

These are interesting. Some of these fears are more common, some less so, but they all seem “weird” enough to the owner that they were willing to share them with complete strangers on the internet.

I don’t know this for certain, but I’d be willing to bet that all of these fears are also a source of shame for the owner. Shame that they’d be embarrassed if anyone found out. That’s how I felt, certainly. For the longest time, I had a “weird” and unexplainable phobia about going on mass transportation – bus, plane, train, whatever. If I wasn’t in control of the vehicle, I was terrified, to the point of a full blown anxiety attack. It wasn’t a fear of death or crashing, I don’t think. I think it was a matter of not being in control of the vehicle, of being stuck somewhere with no way off.

I’m lucky and I was able to get this “weird” fear under control, and while new ones have popped up, this one was put to bed. It took a good chunk of work and therapy, but yeah, eventually I got there.

That being said, if you, dear reader, have some sort of anxiety issue, chances are good that you know exactly what I am discussing when I say that these fears are a periodic source of shame and self-loathing. You feel like such a damn idiot for having such a ridiculous fear of something which the vast majority of people can endure with absolutely zero problem. Why does this fear trigger you so?

What’s the answer? That one is above my paygrade. Some fears are minor things that you can handle, and sometimes they disappear on their own. Others are more serious, rehabilitating issues which require therapy in order to be able to lead a full and productive life.

I do know this one: Don’t beat yourself up over whatever your fear is. You didn’t ask for it, you don’t deserve it, and anxiety doesn’t make you any weaker. If you don’t hate yourself for your random depression or anxiety issues (and you shouldn’t), you don’t need to hate yourself for a phobia.

These “weird” anxieties can crop up for a variety of reasons, everything from negative experiences to trauma. That being said, you don’t have to hate yourself for them. Whatever you fear is, let it go. Self-hatred and anger only supercharges the problem by giving your fuel to burn on.

If you want to share your random anxiety, please leave it below. As always, we welcome your thoughts and opinions!

A More Preventative Mental Health Model

I caught this article in USA Today and it introduced a fascinating concept – one I hadn’t heard of.

Many of you are likely familiar with the National Suicide Prevention Hotline, which has been used to stave off countless crises and has likely saved thousands of lives. Of course, calling this number is what you do at your worst moment – when you are at the bottom of the barrel and feel as if you might hurt yourself because you have nowhere else to turn.

What if there was a way to reach a person before it hit that crisis point?

Introducing the “warm line” from the Mental Health Association of San Francisco. From the article:

Unlike a hotline for those in immediate crisis, warmlines provide early intervention with emotional support that can prevent a crisis – and a more costly 911 call or ER visit. The lines are typically free, confidential peer-support services staffed by volunteers or paid employees who have experienced mental health conditions themselves.

In other words – someone can call, get support, talk to someone, and get access to more resources, thus potentially preventing a more expensive and serious crisis.

This is a great idea, and according to article, a wildly popular one. But, does it work? Will it cut down on arrests, suicides or other mental illnesses? According to one analysis, yes.

Here’s the real reason this appeals to me: It’s a paradigm shift. It’s so much more than just a band-aid or a cure for someone in a crisis. Don’t misunderstand – that’s incredibly helpful, and necessary. But what if we can stop someone from getting sick in the first place?

If you stop a physical illness before it gets infected, you save money, time, pain and lives. Hopefully, programs like this can help push in more into that sort of space when it comes to how we discuss, treat and cure mental illness. It’s why we should try to teach mental health in schools. It’s why physicians should conduct mental health screenings on routine exams. It’s why mental health first aid should be taught alongside physical health first aid.

We can stop these problems before they start.

Do you have a puppy folder?

I had a couple of rougher moments over the past weekend. No real reason, just work and stress – the standard stuff, really. I will admit that I was surprised by how intense it was, but these things happen.

Anyway, I was talking with my wife and trying to snap myself out of it, and with a laugh, I pulled up this video.

The background: I was speaking at an event announcing the moving of the Da Vinci Science Center into downtown Allentown (a big deal, locally!). I was surrounded by elected officials, major developers, local residents, the works. And the microphone just went, “Nahh, f&ck you, I ain’t working.” So we have massive feedback, followed by the microphone just straight up falling as I tried to speak. I know it sound stressful, but honestly, it was hilarious for me, and if you watched the clip, you can see I handled it just by laughing at myself. It wound up being really funny (side note: When faced with an embarrassing situation, just lean into it).

Anyway, whenever I watch this clip, I always get a chuckle. And that’s sort of the point of this entry.

On Monday, I spoke about the need to develop specific tactics which can help you fight back against your anxiety. Things that would temporarily distract you from where your head was swirling off to in order to break the cycle of anxiety and get you out of an attack.

This entry is more or less the companion entry for depression. My suggestion: Have a puppy folder. Have a folder (digital or physical) which you watch that features adorable videos which always cheer you up or make you laugh. It can be movie bloopers, cute pictures of puppies, whatever.

By the way, I do mean, literally, have an actual folder. As you probably know, when you go down the rabbit hole of depression, it can be extremely difficult to pull yourself back out, or to do anything which has even the slightest bit of self-care involved. That’s why I say you should have an actual folder, a one-stop shopping sort of place: When it comes to self-care in your darkest moments, you need to make it as easy as possible for yourself.

To be clear, this isn’t a long-term strategy. It’s a tactic, and there’s a difference. If you find yourself having these dark moments more frequently, if they turn to thoughts of self-harm, or if you start to lose productivity and the ability to function, you need to do more than just watch funny videos: You probably need to see a therapist.

That being said, everyone has down moments. The tactic of a puppy folder can help you break the cycle. It can feel good and give you a moment of joy, and that moment can turn into the foundation for getting yourself out of a rougher moment.

Any videos, pictures or websites which you use on a regular basis to get yourself out of that darkness? Let us know in the comments below!

 

4 Tactics to Stop A Panic Attack In Its Tracks

Ah, panic attacks.

Last week, I wrote about the difference between panic attacks and anxiety attacks. They are both nightmares, of course, but I’d argue that panic attacks are the more intense, nightmarish ones. I consider myself deeply lucky that I haven’t had either in years, but I still remember the pain: The feeling that my bowels were going to turn to liquid, the heart racing, the desperate desire to escape and sensation that you are going to crawl out of your own skin at any moment.

Defeating panic attacks takes quite a bit – often some combination of therapy, medication or tranquilizers. It takes planning, effort, and strategy. However, there are also tactics which I think you can use in order to defeat or slow a panic attack. Yes, I mean tactics: Specific things which you can do in order to feel more powerful and regain control over your own body and mind.

Here are 4 of them:

Pick a Number. Add By 7. Repeat.

My anxiety was out of control in college, particularly senior year. That time period ultimately resulted in a medication adjustment, increased therapy and the development of a series of tactics with my therapist to stop an panic attack. And this one worked, a lot.

When you have a panic attack, your mind just whirls out of control. The key – as exemplified by this effort and others – is to stop it from doing so. To that end, you have to distract yourself.

So, ask yourself? What’s 1,054 + 7? And then another 7? And then another? Get bored? Subtract by 8 now. Just keep going. Take all of that mental energy you are feeling and put it elsewhere. Do whatever you can to break the chain of anxiety which has wrapped its way around your neck.

Notice Stuff

I actually got this one from a LifeHacker article, and it apparently came from BoJack Horesman. Specifically, two characters are talking, and one starts having a panic attack. The other asks him to notice the things which are giving her anxiety, and then start noticing and describing the more mundane things. Chairs. Tables. Lamps.

I think this one works similar to my example above, but with a different basic idea: You try to distract yourself by immersing yourself in another activity. This, of course, can be impossible to do when your mind feels broken, but it is absolutely worth the effort. With this tactic, you try to lose yourself in something else. You find a detailed object and go DEEP. What color is it? What do you think it feels like? When was it made and who do you think made it?

Allow your mind to run away from itself.

Guided Visualization

Guided Visualization is just what it sounds like – you use it to escape your own mind. Either through an audio or visual file, you follow the narrator on a journey. It often involves breathing deeply and relaxing.

Thanks to YouTube, there are no shortage of examples. Even better is that many of them are highly specific to panic attacks.

I’ll say this: These were hard for me when I had bad ones. When they were on their way out or just starting, my wife could often give me a visualization scenario that worked, but as the panic heated up, it became even harder to focus on visualization. Everyone is different, of course, and I hope this works better for you than it did for me.

Understand What’s Happening

Yes, I understand that this one sounds utterly ridiculous, but if you are capable of thinking logically (big if – big big if), this may be helpful. On a biological level, a panic attack is a misfiring of your body’s flight or fight response. Your brain perceives a threat when none exists. As such, you have to try to trick your brain into coming back to reality.

Difficult as it can be, try to take a step back, something akin to mindfulness. Say to yourself: “This is just a misfiring of the neurons of my brain. Nothing is wrong. There is no threat. I am safe.”

If you can understand what is going on – that there is no threat – you may be able to get yourself out of the attack.

As always, I welcome your advise. And also, please understand, much of what I wrote will not work for everyone. Or maybe anyone, I don’t know. But these things did help me – and I hope they can help you, you too.