Anxiety Attacks: techniques for stopping them ASAP?

[MrsBertMacklin]

I get anxiety attacks when I have to use trains in rush hour, or if I have to drive in rush hour, manifesting themselves with the typical symptoms, but for added fun, the physical symptom of needing to go to the toilet (and of course being on a train, there aren't any toilets, so the anxiety expedites).

I had CBT when these first started and I remember my training from this which has been working okay for the last couple of years, but the attacks have started up again recently and my coping training isn't getting 'on top' of the attacks fast enough. So I've been late for work a lot, because I've had to get off the train halfway to find a toilet and calm down or I've been late leaving in the car, because I'm having an attack about getting in the car.

I will be going to the GP soon, but can't get there for practical reasons until later this month.

Can you please give me any tips or tricks you use to stop attacks in their tracks?

My learnt technique is to be quiet, breathe, tell myself I'm going to be okay, count backwards and also remind myself that my body won't let me go to the loo until I'm near a loo. But it takes a good 15 - 20 minutes for this to work.

Thank you for any help you can offer.

You are doing well. The technique of breathing and reassuring yourself sounds really good, so keep on with that. Focus on your exhale - do you know how to do diaphragmatic breathing? - this can help and can slow down your breathing. Is it possible to listen to some relaxation exercises or mindfulness scripts while you are on the train? It could give you something to focus on. There are lots of good apps out there for mindfulness and this helps with anxiety, because it gets you more distance from your thoughts.

You will probably remember from CBT that every time you give in to your anxiety, e.g. not getting in the car, getting off the train halfway, is reinforcing the fear, and strengthening the belief that you can't cope. So try to resist the safety behaviours (easy to say I know). Do it bit by bit if you need to. So say to yourself you will stay on for a few more minutes each day.
You could go the whole hog and conduct a behavioural experiment, e.g. don't go to the toilet before you leave, to prove to yourself that you can manage.

Thanks Majestic, I'll download some stuff tomorrow. I find music exacerbates the attack, I get overwhelmed by the noise, really weird. But I remember having some meditation downloads involving an ice palace, the last time they got this bad, which helped.

I'd actually forgotten about the 'not giving in' advice! They're so bad at the moment though, I was fighting the urge to scream out loud in the carriage last week and I think the poor woman next to me thought I was in labour with the amount of deep breathing and pushing my arms against the chair.

Op, I also suffer with anxiety that, at times involves toilet urges. It used to be especially strong around driving.

Funny enough, hypnotherapy was a big help with that, as was getting a good sat nav. I try to take care of physical stuff before I get in to situations that I know will provoke anxiety attacks, so that I'm awake, fed, in comfortable, breathe-able clothing (cold sweats) and I'll wear a pad in case of toilet urgency. (I haven't needed to actually use one, but I feel more confident if it's there.) if I can, I'll have a friend chat or text me through tough situations too. Good luck.

I understand that my attacks are a symptom of not feeling in control of something in my life, but I have never worked out what caused this to arise when I got on a train. There's lots of other situations where I'm physically 'stuck, e.g. lifts, planes, tube, so I've often thought about there being a way to 're-set' my brain to the time before I associated trains with attacks.

So how have I never thought about hypnotherapy - don't suppose it's on the NHS is it, or if not can I ask my GP for a specific referral when I see her?

I have similar problems on trains and have also found hypnotherapy useful, though actually downloadable hypnosis CDs have been as good as seeing an actual therapist, as long as you do them every night. Rick Collingwood's Anxiety CDs are good, as long as you can put the idea that he sounds like Alf from Home and Away out of your head .

Thanks so much everyone, I thought i was going to have to do a needy bump on this tomorrow, so thanks for being around this evening.