Hacker News Reader

> What I've learned in the months since is that in order to overcome the panic and anxiety you have to do something very simple yet seemingly incredibly difficult; you have to let it happen. Let the panic wash over you. Don't run. Don't distract yourself. Close your eyes and focus on breathing from your belly--deep breaths from the belly rather than shallow breaths from the chest. And then pay attention to where the panic is and what it feels like. Just observe whats happening and let it happen.

    "I must not fear. 
     Fear is the mind-killer. 
     Fear is the little-death that brings
       total obliteration. 
     I will face my fear. 
     I will permit it to pass over me and through me. 
     And when it has gone past I will turn
       the inner eye to see its path. 
     Where the fear has gone there will be nothing
       ....only I will remain"
     -- Frank Herbert, "Dune"

I had some brief moments of anxiety when I was growing up -- I never sought any treatment, but the coping mechanism I developed was essentially what you describe. I suspect others have had more/stronger problems -- for me the thing passed after a few years, and so far hasn't come back.

I certainly recommend seeking treatment with any illness that is bad enough that it causes problems in daily life -- I'm sure I would have needed treatment if it didn't just pass "on its own".

I've done this too, and 'leaning in' and observing rather than fighting the feelings definitely seems to help, in general. Perhaps that's why meditation can often be so effective.

  > What I've learned in the months since is that in order 
  > to overcome the panic and anxiety you have to do 
  > something very simple yet seemingly incredibly 
  > difficult; you have to let it happen.

I believe you're referring to some form of Cognitive-Behavioral Therapy: http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#An...

Exactly. Treating panic the same way you might treat a fear of snakes for example. Gradual exposure to it until at some point the brain recognizes that feeling as not dangerous.

I would just caution that to some people with an underlying inclination towards a "background anxiety", some anxieties never leave, even when getting exposed to situations that trigger them.

So is that a name doctors, after much painstaking research, slapped on top of what has been known for millenia as meditation? Because that's exactly describing something like vipassana, or mindfulness meditation. Sometimes it's funny to watch the west's child-prodigy "scientific method" take so long to come around full circle at age-old wisdom, in this case something that's probably been known from before Civilization.

Yes, but no one talks about the 99 other snake-oil, age-old wisdoms that the scientific method debunked :)

Well, some people still do. Examples include homeopathy, intercessory prayer, and those guys who make YouTube videos of themselves chanting at you to cure diseases somehow.

(Caveat: I assume those chanting videos are part of an age-old tradition, because the people in them say so, but they may not be the most reliable source of information.)

From wikipedia:

  > A basic concept in some CBT treatments... a technique 
  > where the patient is gradually exposed to the actual, 
  > feared stimulus.

This is not merely "describing something like meditation." The subject may be taught meditation techniques to help them learn to stay relaxed when exposed to the anxiety-causing stimulus, however, the therapy is not meditation alone.

For example, the military has been experimenting with using virtual reality to "expose" soldiers suffering from Post Traumatic Stress Disorder (PTSD) to a combat-like experience, since it's too dangerous to expose them to actual combat during therapy: http://www.nami.org/Content/NavigationMenu/Top_Story/Using_V...

Haha, to a certain degree you're right. There is more to it that is different from meditation. But I've been a semi-regular practitioner of meditation for a couple of years now. In fact, the big attack I had earlier this year was while I was at a meditation class!

Had I followed what is taught in meditation I'm sure I would have eventually had the same result. But as a very technical, science-oriented person its nice to know that there is research behind what our ancestors realized a few thousand years ago.

Fortunately, there is more to this than meets the eye. It is unlikely that a patient will come to a halt during a panic attack, say "Wait. I just need to breathe, slowly."

If you haven't experienced a panic attack, it could be difficult understand why some people are unable to act rationally and control their anxiety. However, this is one of the symptoms. Immense fear is disabling. Depending on the severity, one may just need to remove themselves from the situation, fast. I have left meetings, presentations, and other importance face-to-face appointments, because of anxiety. Sometimes, it's just not worth the internal torture.

CBT is not syntactic sugar for meditation. Well trained therapists work carefully to control the stimulus, testing slight attitude changes vs. physical response. Think optimization in the presence of singularities. The average meditation coach is not required to steer a client away from paths to delusion, expose akrasia, or recognize more serious mental illnesses. Insufficient treatment frequently results in depression, mania, schizophrenia, and suicide. These are important problems, and presently, state of the art is well beyond a 'reinventing of the wheel', despite the simplified view of that Wikipedia article.

Science is the new excuse for close-mindedness in the modern world. "I don't believe it before I see it" has been replaced by "I don't believe it before I see peer reviewed research papers about it, which I can easily digest through a news outlet". Who needs curiosity or open-mindedness when you can just wait for others to do the heavy lifting for you.

DISCLAIMER; OF COURSE the scientific method is great. But if you swear by not believing anything that hasn't been peer reviewed, you might come late to the party. In this case, a millennia or two late to the practice of meditation because there wasn't enough research on it, and because it was "too mystical", shivers. Who would have thought that sitting and quieting the mind could be so scary?

No need to be so contemptuous of science. Science is a tool that can reveal truths which neither mysticism nor the Socratic method can approach. Similarly, there are many truths which are intractable to science for various reasons. Only the foolish put all their eggs in one basket of knowledge.

What sort of therapy did you get? I went to my GP and he dismissed it as lack of exercise. Exercise doesn't seem to help me that much though. So I'm at a loss as to what kind of a doctor I should be visiting in the first place

You can visit a psychiatrist because all others will dismiss you.

Note that these days, at least in the US, generally a Psychiatrist mostly just prescribes medications and Psychologists are where you go to "lay on the couch" if you will. My therapist (Clinical Psychologist) prefers you not be on medication and feels strongly (and I'm inclined to agree) that you can find recovery without it.

A Psychiatrist is a Psychologist which can prescribe medication. I don't know how it works in U.S. but here they just ask you at the start of the session what your thoughts are on medication and they tend to be more happy if you refuse it. It's more sessions for them anyway in the long run.

If you are in the U.S., Psychiatrists will often ask who your therapist is. If you are in the U.S. keep in mind that they may be expecting you to work through traditional therapy while they work on your drug regimen. They certainly know how to offer non-drug therapy but many have become medicine coaches due to the way the system works / patient expectations work.

At least here in the US, psychiatry is a specialization of medicine, and a psychiatrist is an MD, while psychology isn't a specialization of anything, and its practitioners' credentials vary widely. The disciplines don't really have much inherent overlap; nobody goes to a psychologist for a prescription, which they can't provide anyway, and nobody really goes to a psychiatrist for "talk therapy", which they mostly prefer to leave to the psychologists whose primary realm it is.

As @jt2190 mentioned I believe its a form of Cognitived Based Therapy/Exposure therapy.

Dismissing it as simply a lack of exercise, in my opinion, is reason to find a new GP. That said, getting more exercise is always a good thing. As is eating healthier. Cut back on the sodas and caffeine. Though, as my therapist said, unless you're unusually sensitive to caffeine you shouldn't have to cut it out completely in order to stop panic attacks.

Another thing I did was had my GP test my vitamin B, D, and magnesium levels. I was low on all and being low may be a contributor to anxiety so I started taking supplements. I'm trying to identify foods I like that are high in them so that I can get them more naturally.

Also, and this is another key point that I should've mentioned before, fear can only exist in a vacuum. So talk about it! Lets get rid of this "I'm a fearless American MAYUN!" bullshit. We're ALL afraid. We're ALL vulnerable. Its ok. It doesn't make us weak.

What I've learned in the months since is that in order to overcome the panic and anxiety you have to do something very simple yet seemingly incredibly difficult; you have to let it happen. Let the panic wash over you

I must not fear.

Fear is the mind-killer.

Fear is the little-death that brings total obliteration.

I will face my fear.

I will permit it to pass over me and through me.

And when it has gone past I will turn the inner eye to see its path.

Where the fear has gone there will be nothing.

Only I will remain

This post was very important for me. I've been struggling with anxiety lately without knowing it. I've been having a very hard time. "Pass Through Panic" really helped me a lot, and I'm starting "Hope And Help For Your Nerves". I can't thank you enough for sharing these resources.

Good luck my friend!

Could you give an example of "something very simple yet seemingly incredibly difficult" -- and how do you come up with your own such "tasks" that are most well-suited to yourself?

The simple yet difficult thing is to let the panic happen. When you run away you're distracting yourself which can dissipate the panic but it only prolongs it. So instead of being at a 10 you're at a more manageable 6. But you're there for hours. Letting the panic happen means you're at a 10 for a few minutes tops and then you're down to below a 2 pretty quickly.

I didn't come up with the tasks on my own. I learned them while working with my therapist. What seems to work for me is to run up and down a flight of stairs a 3-4 times and then breathe through a straw for about 45 seconds while holding my nostrils closed.

I'm getting plenty of air but my brain's reaction is to flash panic. The first flash is around a 6 for about a second or two. Very easy to manage. But I stay present for those few seconds and even try to make it last. Try to have the panic.

I do this for about 20-25 minutes every other day. In this way I expose myself to little bits of panic consciously. When an actual panic attack happens now (which it still does on occasion) its increasingly less severe than the last time. And each time I recover more quickly.

But most importantly, I now know a part of me I never really knew. I have and have always had a strength I wasn't even aware of. All I had to do was look fear in the eye and watch it shirk away.