Q. During this holiday season every time I go into a crowded store, I get hot, sweaty, and my heart starts pounding. It does not happen to me at other times. Could I be having panic attacks? What can I do about it?
A. Since it only happens under these conditions, it sounds like you are having panic attacks. Even though it may be frightening to you, many people experience these feelings when stores are crowded and one is bundled up for the winter. Becoming overheated can signal the beginning of panic, then one becomes frightened, and the episode begins to escalate.
As a panic attack sufferer myself, I can attest to the effectiveness of some simple behavioral techniques that you may find helpful. First, remove your coat before you go into the store. Second, the moment you experience the first symptom, slow down your breathing. As you breathe more slowly, you will notice that your heart rate slows down. Third, touch something cold or have a drink of a cold beverage. Lastly, it sometime helps to chew gum or take an antacid. If you are in a line when the panic begins, do not lock your knees, but keep shifting your weight.
Panic attacks only last a few minutes; however, those few minutes can be frightening. Your sympathetic nervous system, the “fight or flight” response, is becoming overly activated. That’s why you likely want to run from the store. It is important not to flee because it worsens the attack the next time. If you accept the panic episode without becoming too fearful, the parasympathetic nervous system, which balances the sympathetic system, will activate and the anxiety will subside.
There are several books on overcoming panic attacks that you may find useful. I recommend “Master Your Panic” by Denise Beckfeld, Ph.D.
Q. My 80-year-old mother, who lives alone, doesn’t leave home because she says she is anxious. It has become worse since the weather is colder. What can I do to help her?
A. If this desire to stay home has occurred suddenly, your mother should have a complete physical with a gerontologist. She could have a physical problem that has little to do with fear. Additionally, check her medications. Be certain that she is not taking anything that causes an increase in anxiety.
Ask about her fears. Is she afraid she will fall? Does she get too cold outside? Is she becoming depressed because of the early darkness? Your mother needs encouragement from you and other family members. Try to get her involved in activities and take her out as often as possible.
There are also some precautions she should take. Oftentimes, older people become frightened if they hear news about crime. It is important that she keep up with community events, but too much negative news can cause an increase in anxiety. If she hears there is a robbery, even if it is not close to her, she may suddenly be fearful of living alone. Be certain that you have made her home as safe as possible, and that she is comfortable with her surroundings.
If she continues to have problems, her physician should refer her to a mental health professional. It is not uncommon for someone elderly to develop an anxiety disorder. According to the Geriatric Mental Health Foundation, 10 to 20 percent of older adults have problems with anxiety, and they often are undiagnosed.
A psychotherapist can teach her relaxation techniques, calm some of her fears, and provide reassurance. If her anxiety continues, there are also many medications for anxiety and depression that have been shown to be effective in relieving distress in the elderly. Your family doctor in conjunction with a mental health professional should be able to prescribe those if necessary.
Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City. She currently teaches psychology at Southeast Arkansas College. If you have questions, e-mail them to firstname.lastname@example.org. They will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.