Part Two: What is the Connection?
[A three-part series]
As I discussed last week, stress may be defined as how the body reacts to any change and how we go on to think about those reactions. It's probably no surprise to many people with panic disorder that there is a connection between panic and stress.
| "The effects of OVERSTRESS cost our society at least 60 billion dollars a year" -- Dr. Steven L. Burns, from How to Survive Unbearable Stress |
What can be confusing is how stress and panic are connected and what you can do about that connection. You might also be wondering if stress reduction can help you with your recovery from panic disorder. The answer is "yes," and here's why:
Cholecystokinin
Current panic disorder research has been focusing on a neurotransmitter called "cholecystokinin" or "CCK." CCK may cause panic attacks in some people (perhaps those with a genetic predisposition to panic disorder). When the body is under stress, it produces endorphins. When the stress ends, the body produces CCK to counteract the endorphins. Thus, the physiological reaction produced by stress may cause panic attacks in some people.
|
DON'T MISS the other installments in this series: |
CCK is found in both the brain and the stomach which may explain why so many gastrointestinal problems are associated with both panic disorder and stress. Using a flowchart, Dr. Stuart Shipko (a psychiatrist/neurologist at the forefront of CCK/panic research) explains other possible symptoms of excess CCK associated with chronic stress.
Cumulative Stress
As Edmund J. Bourne states in The Anxiety & Phobia Workbook, "The frequency of panic attacks and the severity of phobias tends to wax and wane depending on how well you cope with the daily stresses of living." When I think about the fluctuations of my illness over the years, I realize how right Bourne is.
The effects of stress can build up over time. And, remember, all change produces stress. Even the smallest of changes produces stress. If you are healthy, physically and mentally, you may not even notice the small stressors in your life, and you will be better able to handle the big ones.
|
|
But if you're not exercising and you're eating poorly, if you never have any fun, if you let anger eat away at you every day, stress may overwhelm you, physically and emotionally. It's been known for a long time that cumulative stress can contribute to illnesses such as ulcers and high blood pressure. The CCK research mentioned above offers one theory why chronic stress may lead to psychiatric conditions such as panic disorder.
Many factors may add to what Bourne refers to as "cumulative stress." If you experience a number of major life changes in a short period of time, you may feel the effects of cumulative stress. You will also be more vulnerable to the effects of smaller changes in your life. In other words, the effects of stress can build up. Other factors leading to cumulative stress may be relationship difficulties or internal conflicts about past traumas or problems. When all or even a couple of these factors come together, it could indeed trigger panic attacks in someone predisposed to having them.
|
AT THE PANIC DISORDER SITE |
To me it means that learning about and coping with stress is just as (if not more) important to me as dealing with the panic attacks themselves. For me, the more stress I am under, the more likely I am to experience nocturnal panic attacks and anticipatory anxiety (both which lead to further problems like insomnia, depression and agoraphobia).
As I wrote last week, there is no way to avoid stress because you cannot avoid change. As someone with panic disorder, I know that I have to cope with stress because, as the research above has shown, not coping with stress will make me vulnerable to a relapse of panic.
|
|
Luckily, many of the same coping techniques for stress also help with panic: relaxation, breathing, exercise, anger management, better diet, etc. Many (most?) times, it's difficult to see how performing daily relaxation techniques would ever help me deal with a severe panic attack. I've come to see, though, how the relaxation exercises help with stress. The stronger I make myself, physically and mentally, the better I will cope with stress. It's simple in theory, but not always easy to do. Next week, I'll show you how you can start.