Coping With Panic Attacks in Bipolar Disorder

Coping with panic attacks
Hyperventilation is one symptom of a panic attack.. Peter Dazeley/Photographer's Choice/Getty Images

When I polled some of my readers about what concerned them, several said they wanted information on coping with the panic attacks they get along with their bipolar disorder. A little research showed me that there's a high comorbidity of bipolar disorder and panic disorder, so I went digging for the best information I could find on easing panic symptoms.

Katharina Star, our Guide to Panic Disorder, has a good overview of strategies for getting through a panic attack.

Below I've broken down various techniques that can be useful.

Deep Breathing to Reduce Panic

1. In Taming the Fight or Flight Response, yoga expert JoAnn Revak talks about some of the biological reasons why breathing becomes difficult during times of high anxiety, and gives instructions for an exercise that is effective for opening up the lungs to allow deeper breathing.

2. In Easing Anxiety Naturally, Ms. Revak offers a different exercise that works well after discharging physical tension. She has some suggestions for doing this, too. Bear in mind that activities like dancing or jumping jacks may not be suitable if you have any problems with dizziness or balance (common side effects of some medications).

3. Check out How to Practice Diaphragmatic Breathing by our Guide to Social Anxiety Disorder, Arlin Cuncic. The diaphragm is a sheet of muscle that is integral to expansion of the lungs. The shortness of breath that comes with panic attacks responds well to conscious effort to breathe clear down to the deepest part of the lungs.

Relaxation Exercises

1. Alternative Medicine Guide Cathy Wong writes about the Relaxation Response, a technique that can be practiced daily (or at least 4 days a week) in order to ease overall stress.

2. Ann Pfizer, our Guide to Yoga, offers Yoga Techniques for Anxiety Attacks, including breathing exercises, stretches and using a mantra to clear the mind.

You may also want to take a look at her article Yoga for Stress, an overview that links to more in-depth information about using yoga to make your body less susceptible to stress.

3. Progressive muscle relaxation is a tried and true method of releasing physical tension. If your muscles tend to cramp when you deliberately tense them, as mine do when I'm already tightened up, look for a method that uses visualization instead, or try autogenic training (below).

4. From Barbara Bolen, About Guide to IBS, comes Visualization for Relaxation. I've used this technique myself and found it both pleasant and effective.

5. Autogenic training has been extremely helpful to me. This relaxation technique involves repetition of cues to relax parts of the body in sequence. I've done it on my own and have used audio resources as well.

Medications and Therapy

1. A commonly used class of medications for anxiety and panic disorder is the benzodiazepines. Although there is some risk of developing tolerance or dependence on this category of medication, they have been found to be highly effective in treating people who suffer from panic attacks and panic disorder.

In addition, antidepressants, particularly the SSRIs, are often used to decrease the symptoms of panic disorder.

2. Cognitive behavioral therapy (CBT), says Psychology Guide Kendra Cherry, can be very effective in treating panic attacks. One of the things CBT focuses on is identifying recurrent negative thoughts so they can be altered. The only drawback I know of is that not all insurance covers CBT (mine doesn't).

Bipolar Disorder and Panic Attacks - Conclusion

It's important for you and your doctor to determine whether you are having panic attacks because of your bipolar disorder or if you do have panic disorder as well as bipolar. Professional treatment in the forms of medication and therapy may differ depending on that determination.

Regardless, though, there are tools at your fingertips for helping yourself when anxiety builds into panic, or a panic attack comes out of nowhere. If you familiarize yourself with do-it-yourself techniques when you are not panicking, they will be easier to implement when you are.

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