Recognizing and Understanding Panic Attacks

I have heard it described many times before.

It usually starts with, “I didn’t know what was happening to me.”

They then go on to describe an overwhelming feeling of fear. Feelings of dizziness and or being a little lightheaded come on. Palms sweat and sometimes shake. Their face feels flushed. Blood pressure goes through the roof.

Often the first time it happens it is shrugged off as just an odd episode. It’s not until it happens a few more times that the person realizes it is time to seek some help. They are usually thinking that they must be ill. What they learn is that they are not in fact ill, but are experiencing panic attacks.

Anyone can suffer from a panic attack. Many people who experience them do not immediately recognize the source of their discomfort.

The good news is that panic attacks are easily explainable and with the guidance of a therapist they are also treatable.

What is a Panic Attack?  

Mental health professionals describe panic attacks as sudden rushes of intense dread or distress which are often accompanied by a number of physical symptoms that can include: dizziness, sweating, a racing heart, chest pain, difficulty breathing, trembling, numbness, and even disorientation.

Inside the brain, things can be just as concerning. During a panic attack one will often experience thoughts of fear and dread as well as a fear of doing something uncontrollable or of dying.

Panic attack sufferers are not actually dying. Their blood is pumping with adrenaline. Their bodies are reacting in the same way it would if an immediate threat was present.

In simple terms, their body has triggered their “fight or flight” response in order to protect the individual.

Obviously, there is often no immediate threat when a panic attack sets in. The mind realizes this, but the body ignores this information. The body is saying run. The mind is saying stay. The confusing signals between the mind and body will cause the person to stay in one place.

What Can Cause a Panic Attack?

There is no typical profile for a person who is prone to experience a panic attack. Typically, someone who experiences panic attacks has their first panic attack as a child, but not always. Women tend to experience them more than men, and some research points to genetic dispositions.

Even though panic attacks can seemingly sneak up out of nowhere, they can be triggered by a lack of sleep, drugs, caffeine, alcohol, as well as chemical or hormonal imbalances. Many times they are also often connected to traumatic or challenging life situations, most often ones that have occurred in the past 12 months.

Individuals who experience regular panic attacks cannot often predict when they’ll strike. They find they are more susceptible when they are under extreme stress. Other times they will strike seemingly randomly.

What Can You Do if Experiencing a Panic Attack?

If someone has been diagnosed with panic attacks, they can often make simple lifestyle adjustments to reduce symptoms. Things such as getting more sleep and exercising more regularly can help.

Although they are not recommended for frequent use because they can be habit forming, anti-anxiety medications such as Xanax can be useful for specific situations that are likely to induce panic such as sailing on a boat or flying on a plane.

If panic attacks start to occur frequently, there is a possibility that the the individual has a panic disorder. In the case of a panic disorder, the individual becomes so worried about having a panic attack that their anxiety becomes a source of more anxiety.

To avoid having another attack, they will try to stay away from situations, people, or places that trigger their symptoms. If they feel panic setting in, they will try to fight the fear, which unfortunately, usually makes it worse.

Panic disorders can be managed in the short-term with antidepressants, but are best treated through cognitive behavioral therapy. Cognitive behavioral therapy is a treatment that tries to help patients tap into the thoughts and feelings that drive their actions. Through this therapy they can identify and examine the fears that trigger their anxiety.

The goal is to break the cycle of panic through anxiety counseling. By understanding what causes the feelings of panic, an individual does not have as strong of a physical or emotional response to it. With this new found understanding, they can recognize the feelings of panic for what they are and adopt coping skills.

If you experience panic attacks and are ready to get started learning why, you can contact us to schedule your first appointment.

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Prioritize Your Mental Health in 2017

make your mental health a priorityWhile your friends and family are resolving to cook more dinners at home; to lose 50 pounds; to travel more; or to check seeing Tom Petty in concert off the old bucket list, but you’re starting smaller: with yourself. You’ve decided the year 2017 is the year of you.

2017 is the year you have chosen to make your mental health your priority.

Your mental health affects how you think, how you feel, and how you act every day, in every situation. Your mental health affects the way you perceive yourself and how your friends, loved ones, and strangers perceive you too. Your New Year’s resolution for 2017 is to become a better — nay, the best version of yourself by improving your mental health.

Meditate.

The practice of meditation has been shown to offer a variety of health benefits, including improved sleep and decreased anxiety. But it is a practice. To reap the rewards — even and especially when the status quo is ‘busy’ — set aside ten minutes per day to quiet the noise. Take a few moments to reflect on the day; express gratitude for the blessings in your life, and focus on becoming fully present.

Commit to regular exercise.

Exercise is great not only because it releases endorphins in your brain that make you a happier version of yourself, but it helps you work toward that other goal of losing weight. Even better, when the weather is nice, get outside. Research has suggested that walking outdoors surrounded by nature has even more mood-boosting power.

Find your tribe.

Winter is cold and it’s dreary, and for those who struggle with Seasonal Affective Disorder (SAD) it’s even worse, but getting out of the house — social connection and bonding are imperative to mental health, so go on. Get out of the house and do something fun; make new friends. Go to the beach, or schedule a car service for a night on the town. It’ll be worth it.

Eat well.

Healthy eating leads to healthy bodies and healthy minds. Strive to incorporate many different types of fruits and vegetables in your diet, and other tasty brain boosting foods like walnuts. Don’t skip meals, and stay hydrated, and you’ll be well on the path to prioritizing your health and mental well being all year long.

Schedule an appointment with your Washington DC psychotherapist.

The wisdom and guidance of a professional psychotherapist in Washington DC can help you onto a path of self-discovery, and toward more effective methods of dealing with depression, stress, anxiety, and every day life.

Contact Keith Miller Counseling & Associates to discuss how psychotherapy in Washington DC can help you achieve your goal of a happier, healthier you in 2017.

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When Your Way is the Right Way: The Methodology of Persuasion

Persuasion methodology | Bethesda psychotherapistTo be persuasive is an important skill that can help you get ahead — and make you happier — at work, at home, and in social situations, too. But that’s not all it’ll do: Learning the tricks of persuasion can also provide unique insight into how and when they’re being used on you.

Consider the following subconscious, but very persuasive techniques.

With these simple techniques, and a little practices, soon you’ll convince everyone around you that your way is the best way, and leave them wondering why they ever thought differently.

Use framing to influence thought.

Framing, put simply, is a way to change how we sort, categorize, associate, and assign meaning to events, objects, or behaviors. An example? A pessimistic person would say, “This glass is half empty.”, thus calling specific attention to the empty part of the glass, while an optimist uses language to point out the full portion of the glass.

There is where the power of framing as a tool for persuasion lies. The word you choose will conjure images that carry positive, negative, or neutral connotations, thus influencing how the person to whom your are speaking feels or thinks about a subject.

Use the mirroring technique.

This practice of mimicking the movements and body language of the person you are trying to persuade creates a sense of empathy; he or she will understand that you understand their problem or need, and will more readily accept the solution you have offered.

Mirror hand gestures; lean forward or away from the person; or mimic various head and arm movements. The truth is, we all do this naturally, and becoming aware of its power will only work the tool to your advantage. But take care to be subtle, so your actions won’t be seen as mocking.

Use herd behavior to influence a decision.

It’s the concept of herd behavior that you’ll find at play behind peer pressure, and herd behavior that caused your mom to say, “If So-and-So jumped off a bridge…” But when employed under just the right circumstances, this tactic has the invaluable power to position you as an effective leader.

Human beings as a species are observant; we watch what those around us do before deciding how to act ourselves, for no reason other than we crave acceptance. It’s for that reason that we are far more likely to follow or be persuaded by someone we like.

Be charming and confident; praise a leader the person whom you are trying to persuade admires; trigger positive thoughts in that person’s mind, and they’ll likely associate those same qualities with you.

To be persuasive is a skill that will help you get ahead and make you happy, and one that requires at least a basic knowledge of human psychology; for more information, and help influencing those around you, contact Bethesda, MD’s experienced psychotherapists at Keith Miller Counseling & Associates.

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Your Brain Deserves a Break This Summer: Take It & Be Mindful

Have a very relaxing summer vacation. Give your brain a break. Be mindful. | Washington DC psychotherapy

The kids are out of school, and pretty much everyone in the office is checked out. It’s vacation season. Nearly half (45 percent) of all Americans who vacation do so in the summer months, July more specifically. To Florida or California, DC or New York, the Caribbean Islands or Europe: We go on vacation to escape, to find a new set of scenes to look upon for a week or more.

We go on vacation because we think that’ll make us happy, but does it really?

Yes.

Well… kind of.

The research indicates that people are happiest while planning, or in anticipation of their vacations, more so than while on or after vacation. But of course there is an exception. The only people who have been found to be happier after vacation are those who can describe their time away as “very relaxing.” That’s the way.

Take a “very relaxing” vacation to maximize happiness all year round.

The secret to a very relaxing vacation isn’t traveling to a specific location, or staying at the most luxurious resorts; no, that very relaxing vacation destination isn’t a destination at all, but a mindset. Mindfulness.

Defined as “a moment to moment awareness of one’s experience without judgment,” mindfulness enhances the capability of memory; it increases your ability to focus, and lessens emotional reactivity; mindfulness also helps make the practitioner more open to change and increases relationship satisfaction.

Take mindfulness on vacation with you.

Vacation is fun, sure, but there’s a reason the majority of us feel more excited and happier before departing. That’s because vacation is also stressful. But if you start now, the practice of mindfulness can mean the difference between feeling stressed and being happy, by keeping you aware of your environment moment-to-moment.

So on this vacation this summer, truly give your brain a break.

Put down your iPhone (or at the very least, turn off your work email). Take a long walk along the shoreline. Do a little yoga. Meditate, or sketch. Try, or do something new. Simply close your eyes and let your senses be overwhelmed by the world around you.

Allow yourself the time, the space and the mental clarity to take in the richness of a new and different environment; and you’ll find the key to being happy, happier, and happiest before, during, and after vacation.

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How To Tell If You’re Experiencing An Anxiety Attack in Washington DC

Worried woman: Psychotherapy for anxietyAnxiety (or panic) attacks are — well — they’re awful.

Anxiety attacks are periods of intense anxiety, or panic that often occur suddenly, and with no warning. They affect the mind, but more so the body, and can cause extreme fear for the sufferer — especially those who’ve never before experienced such a thing — as the symptoms mimic those of other, more severe maladies.

What is an anxiety attack?

To use the more technical term, a panic attack can be best described as severe dread or distress, often attended by painful physical symptoms that can include dizziness, sweating, a racing heart, chest pain, shaking, or numbness. And then there’s what’s going on inside the mind.

A typical anxiety attack will last five to 10 minutes, during which the sufferer will experience extreme thoughts that might lead them to believe they are going crazy, or that they’re dying — none of which is true.

What causes an anxiety attack?

Stress. Remember, last week, when we talked about stress, its effects on the body, and the subsequent ‘fight or flight’ response? The same concept applies here. Stress can lead to panic, which leads to a chemical reaction in the body, which leads to feelings of anxiety and apprehension.

Panic attacks often seem to come out of nowhere, but they can be triggered: By a lack of sleep; by traumatic life events, such as loss; by drugs, alcohol, or caffeine; or by specific chemical and hormonal imbalances.

If you believe you may be experiencing an anxiety attack, take a deep breath, and know that anxiety attacks are highly treatable.

take our anxiety quizSince most symptoms of a panic attack mirror those of a heart attack, most first-time sufferers end up in the emergency room. It’s always a good idea to rule out any physical conditions that might be causing the symptoms of an anxiety attack. Once you’ve determined that what you experienced in Washington DC really was a panic attack, a few simple lifestyle changes — such as adequate sleep, exercise, and the basic skills of mindfulness (detailed below) for as little as 10 minutes per day — will greatly reduce the severity of, or eliminate panic attacks altogether.

What is the best way to treat an anxiety attack?

The physiology of stopping an anxiety attack is incredibly simple yet profoundly elusive in a moment of panic. The scientific reason for a panic attack is this: Your brain and body’s natural defense system — the stress response — shifts into high gear.

See? Simple. Yet complicated.

If you were running away from your neighbor’s pit bull, the major stress chemicals, adrenaline and cortisol, would be needed to help you leap over the chain-link fence fast enough to avoid a nip from the dog. If you were a zebra, once the threat was gone you would mindlessly resume your activities of munching grass.

Zebras don’t get ulcers (or have panic attacks), because they have no prefrontal cortex — that part of the human brain which imagines or re-lives the experience of stress. When your thinking cortex hasn’t hijacked your body, your parasympathetic nervous system naturally kicks in, to soothe and calm your body with just the right cocktail of chemicals.

This is called the relaxation response.

The solution to a panic attack is already inside of you.

Comforted yet? We’re getting there.

You are not defective; your mind and body are not betraying you.

In fact, the opposite is true. Your mind and body are functioning perfectly during a panic attack — perfectly in response to stress, real or imagined.

Researchers and psychotherapists in Washington DC have uncovered the antidote to disorders of the mind and body caused by anxiety and fear:

A simple skill called mindfulness.

How simple is mindfulness? In the most basic form, mindfulness is the focusing of your attention with the goal of diminishing simulation.

To enhance the effect of mindfulness and engage your relaxation response fully, deepen and slow your exhalation and pull your next breath in deeply using rise of your belly to expand the bottom lobes of your lungs. For eight breaths focus only on the sounds of your breath, the feeling of your belly rising and the sensations everywhere in your body — without judgment or analysis.

Simply begin to notice what you are feeling.

Eventually your mind will quiet itself, and begin to wander less. Through the practice of mindfulness, you will learn how to not jump on the endless freight train of thoughts produced by your wonderful and imaginative neocortex, so you can remain still, calm and at peace.

Have panic attacks become a frequent, maybe even debilitating part of your life?

You may have panic disorder — and you’re not alone. Nearly six million American adults suffer from panic disorder. One of Washington DC’s leading psychotherapy and anxiety counseling practices, Keith Miller Counseling & Associates, can help you unlock the potential of your mind and body’s relaxation response.

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Engage in Mindfulness in Washington DC. Disengage from Stress & Anxiety.

HappinessWhen someone mentions ‘the city that never sleeps’, you think of New York City, right? Of course you do. A nickname coined, and made famous by the Martin Scorsese film New York, New York (and with a little help from Frank Sinatra), it’s one that could just as easily be used to describe, well, the world these days. Everywhere I turn, there are lights flashing, and sounds sounding; and everyone is rushing.

It’s really no wonder more and more Americans are struggling with feelings of stress, anxiety, and depression. But I’m here to tell you there is a way out.

You can surmount these feelings of angst, and it may be easier than you think.

How?

Exchange mindlessness for mindfulness in Washington DC.

Mindfulness is, as defined by the expert on the matter — the American Mindfulness Research Association — the “state, process and practice of remembering to observe moment-to-moment experience with openness and without automatic patterns of previously conditioned thoughts, emotions or behaviors.”

The practice, or process of achieving mindfulness usually involves meditation, and has been shown to offer a variety of health benefits, including improved sleep and decreased anxiety. But mindfulness is a practice. To reap the rewards, you must set aside time every day; forgo a bit of productivity and practice being mindful, not mindless.

Press the pause button.

When I mentioned forgoing productivity, you twitched a little, didn’t you? We’re all so busy, and so busy trying to be so productive, we’re largely forgotten what it means to just be… still.

Mindfulness doesn’t require hours of your time to be beneficial. In fact, the best piece of advice I can give you is this: Start small. Set aside a few minutes at the start of every day to reflect on the bigger picture that is your life, and to be grateful, and calm.

Eat mindfully.

It’s true what you hear, that foods high in fat and sugar can have a negative impact on your emotions and well-being. When you choose to eat healthy instead, you’ll have chosen to power your mind, as well as your body.

Healthy eating is a start, but it’s eating mindfully is about more than food:

Turn the television off; put your laptop away, skip the trip to the Beauty Salon. Think instead about the meal in front of you, and the flavors. Savor each bite, and truly give thanks to the food, and all who took care to bring it to your plate.

Be mindful of others.

The practice of mindfulness may be a solitary, introspective one, but as you embrace the stillness and the calm, know that time spent improving your inner self will also improve the way you interact with those around you.

Think of the ones you love; thank the ones you love; help, and give to the ones you love. And soon you’ll find yourself refreshed, newly engaged, and mindful.

Keith Miller Counseling can help you be more mindful in Washington DC.

Contact Keith Miller Counseling & Associates today, and let’s discuss how psychotherapy in Washington DC can help unburden you from stress, anxiety, and depression, and feel more mindful in the process.

SCHEDULE A FREE CONSULTATION

Call 202-629-1949

Montgomery County Counseling Services

Montgomery County counseling services are available to address a variety of individual, couples and family problems. If you are struggling with emotional problems, relationship issues or substance abuse, located in Bethesda Maryland, Montgomery County counseling services can help.

Montgomery County counseling
Image courtesy of Stuart Miles/FreeDigitalPhotos.net

Counseling to Combat Depression

Depression is a very treatable condition, but many people go undiagnosed and untreated for years. Depression can happen to anyone at any point during their life.  It can affect a person’s relationships, occupation, and leisure time activities.

Seek help by meeting with a trained mental health professional.  Montgomery county counseling services can help reduce your depression with a variety of counseling techniques.

Montgomery County Counseling to Address Anxiety

Anxiety comes in many forms. While some people experience panic attacks or a general sense of anxiety much of the time, others have anxiety related to a past trauma. However, talk therapy can be a great way to learn how to manage your anxiety.

Unfortunately, without treatment, anxiety can get worse over time. Montgomery County counseling can help you get your life back on track. Learn how to manage your anxiety and reduce your symptoms.

Counseling for Relationship Issues

Relationship problems can take a big toll on your life. However, Montgomery County counseling services can help improve the quality of your relationship.

Bethesda Couples Counseling can help you learn how to resolve conflict successfully. It can also help improve your emotional and physical intimacy. Counseling can help you get the spark back in your relationship, even when you think there’s no hope.

If you’re not sure whether or not you need counseling, speak to a counselor that offers Montgomery County counseling services. A counselor can provide you with information about available services and treatment options.

Call now and we’ll help match you with the right counselor:

202-629-1949 ext. 0 

KeithMillermap

Montgomery County Counseling Services

Practical/Experiential Therapy for Couples (PET-C) with Brent Atkinson

For about two years now I’ve been hearing and learning about a kind of systematic couples therapy that is sophisticated enough to work with the many facets of struggle that face the couples in crisis in our practice. In particular, I have thought much about what are the best ways to equip our practice to deal with the “treatment resistance” we see in some couples, no matter what brand of couples therapy we are using.

As I compare some of the benefits of the many great couples trainings that exist, I have been very impressed with Practical/Experiential Therapy for Couples (PET-C). PET-C gleans from a comprehensive knowledge of interpersonal neurobiology and uses of experiential therapy to training couples in the behaviors needed to have a successful relationship. BrentAtkinson is the developer of this model, which seems to package the work of the Gottmans, Harville Hendrix, Sue Johnson, Dick Schwartz plus the many neurobiology advances all into a rather neat experiential protocol.

His model, and the focus of this training, is explained in the book, Emotional Intelligence in Couples Therapy: Advances from Neurobiology and the Science of Intimate Relationships (2005), which I highly recommend for any couples therapist.

I think this article by Brent speaks for the appeal of PET-C to give you some sharp tools in your couples tool-bag.

I am excited to announce that Keith Miller & Associates Counseling is planning to host Brent coming to the DC area to present his 5 day intensive training for our staff and all others interested. The limit on registrations is 30 people.

Click here to see a description of the material covered in this training.

The dates of the training will be May 3-5 (Fri, Sat and Sun) and Sept 7-8 (Sat and Sun). Each day consists of 6 hours of instruction plus breaks.

The cost of the 5 day training is $869.

Normally to take Brent’s training is $1100 per person and only offered in Chicago. Travel and accommodations would easily tack on another $1K+ for a total cost of over $2000. The value for getting this amazing couples training in DC is a real deal! In addition Brent’s Chicago training is usually 5 days all at once. We will have the chance to break up the learning, practice, and come together again to fine-tune.

The deadline for registering with me (with payment) is March 29th.

SUMMARY:

WHAT: Brent Atkinson’s 5 day intensive Practical/Experiential Therapy for Couples (PET-C)
WHEN: May 3-5 and Sept 7-8 (approximately 9am-5pm)
WHERE: Holiday Inn
15101 Sweitzer Lane
Laurel, MD 20707
COST: $869
REGISTRATION DEADLINE: March 29, 2013
CE’s PROVIDED: 30 hrs for social workers, professional counselors psychologists ($8 for NASW members and $12 non-members)

CANCELLATION POLICY:

*Cancellations before March 29 shall be refunded in full.
*After March 29th the registration fee is non-refundable.

CONTACT:

Keith Miller
[email protected]
202-629-1949 ext. 2

Dealing with Jealousy in a Relationship

marriage counseling DCContrary to popular belief, jealousy is not a sign of insecurity or weakness. It can also be the way in which people express love. If you are in a relationship, you will inevitably have to deal with and overcome jealousy. However, handling such feelings in a relationship is not an easy task. Jealousy can become an intense feeling and confuse your partner into believing that your relationship is threatened and unstable. If you feel threatened about your relationship due to jealousy, consulting a marriage counseling DC therapist can be a good idea. Continue reading “Dealing with Jealousy in a Relationship”

How to Deal with Aggressive Behavior within the Family?

Family TherapyAggressive behavior might lead to several problems in life. Such behavior can manifest in a person due to various reasons like heredity, unpleasant childhood, and exposure to unpleasant events. Though certain level of aggressive behavior is crucial to defend ourselves, it should not reach an extent where you harm others. Aggression is a very common problem in several families. To control your aggressive behavior, going to a DC family therapist can be helpful. Continue reading “How to Deal with Aggressive Behavior within the Family?”