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Iain Abernethy
Iain Abernethy's picture
Help with panic attacks caused by contact to the face

I received this email from a person who suffers from panic attacks when they get struck in the face. With their permission, I have posted the relevant parts here (maintaining their anonymity) so others can share their thoughts, experience and guidance.

All the best,

Iain

Email received:

I have a past with depression anxiety and panic attacks. I'm out of my depression, and thankfully do not suffer too badly with panic attacks anymore. Except when I get hit in the face in kumite. It's much better than a couple of years ago, but when my stress levels get too high I can feel the anxiety start up. Usually I step aside and control my breathing and get back into it.

On monday, I had my worst panic attack yet, after I got hit in the face. My stress was through the roof all training, and there was no chance for me to control my anxiety. My body froze and I fell to the floor while hyper ventilating.

I believe this has to do with a competition I participated in 10 years ago and got my nose cracked with 30 seconds left of the fight. I'm not scared of sparing now, but my brain reacts non the less.

I was wondering if you had any tips, tricks or exercizes to recommend to overcome this?

If you want you can post this on your forum anonymously. I really want to get rid of this, as I feel it's the last piece of the puzzle for my mental health. I'm looking for help wherever I can.

Les Bubka
Les Bubka's picture

From what I learnt working with people with depression, anxiety best option is to see somebody who is trained in helping people overcoming those problems. There's no one solution everyone is different and need different approach.

For some hypnotherapy does wonders for others CBT and others tapping, at our Karate For Mental Health we will have a presentation from my friend who specialises with hypnotherapy and tapping for PTSD, it will be interesting experience.

As I suffer with anxiety too,( but don't have big panic attacks) very helpful was visualisation, meditation and head on collision, I don't recommend any of those as a therapy as I'm not a health professional, just saying what have helped me. For my anxiety getting used to the experience works best, so I do it over and over again until my brain stops to recognise activity as a threat.

Hope that the person who wrote to you will find help and overcome their problem.

Kind regards

Les

Wastelander
Wastelander's picture

I struggle with depression and anxiety, myself, and have since I was a child, although I did my best to hide it and pretend I was fine, even into adulthood. I'm glad to hear they have gotten to a good place with their depression! Depression can be very difficult to dig yourself out of, and it tends to try and feed off of anxiety, but at least it tends to be fairly consistent in how it manifests in people, and what triggers it. Anxiety is tricky, because it is just so inconsistent! I'm not a mental health professional, so I can't give medical advice in that regard, but my experience, personally, and with friends and family, is that anxiety manifests differently in different people, and the triggers can vary widely, as can treatment options. I would absolutely recommend that they start working with a therapist, if they haven't, already!

With regard to this particular situation, I would tend to think that a form of "exposure therapy" would be in order, but again, I would defer to a professional. My thought would be that being struck in the face is something they would need to work up to--it's not uncommon, even among people without anxiety disorders! For a new student who was nervous about face contact, even without an anxiety disorder, I would generally recommend starting with something they could control. Now, I must preface this by saying that you should NEVER voluntarily be hit in such a way that it can cause a concussion, or other damage/trauma to the head and brain! Things like lightly slapping themself in the face, just to get used to something hitting them in the face, and them being okay, is a good start. You could also do something similar with gloves on--still light, of course. After that, it would be getting someone who is known to have good control do basically the same type of thing, in a scripted manner. Eventually, they do have to make the leap into sparring and having the face contact be a possibility in an unscripted situation, but I would hope that they would have gotten used to the feel of it, and built up enough comfort in knowing that they will be okay, even if they are hit, that they could do so. I think it's also really important for their dojomates to understand the situation, and be supportive and understanding of their personal limitations. This isn't something you just "get over"--it's going to take time.

As I said, that's just my perspective on it, but I would definitely consult a mental health professional, first and foremost.

Anf
Anf's picture

I've been battling my own anxiety crisis complete with full blown panic attacks for about 4 years now. I'm finally getting on top of it. I'm pleased to say that in my case (and every case will be different) I've made good progress without taking my prescribed medication for it.

I must stress two things at this point.

1. Every case is going to be different, so what works for me may not work for someone else and vice versa

2. I'm no way an expert on this matter, just an ordinary person that's going through it and can now see light at the end of the tunnel.

For me, the turning point on the road to recovery was when I started to look at the problem with cold logic. Once I started doing that, I started to realise that in my mind, I was routinely massively exaggerating the worst possible outcome. To give just one example, when next door caused accidental damage to my fence and didn't immediately apologise, in my mind I built up this entire worst case scenario that somehow involved me facing the prospect of some kind of tribal feud between whole families. Once I forced myself to look at it logically, I just fixed the fence. That might sound like a ridiculous story and it is, but that's how my mind was taking the worst possible outcome in every situation, and building it up into something really stressful, and in most cases almost completely implausible.

Going back to the damaged fence scenario then, subconscious builds it up to family feud resulting in my family being forced out and having to move. Conscious logical analysis finds that yes, that could happen, but it's about as likely as finding Elvis Presley working in the corner shop. Much more likely outcome is I fix the fence, and we all get on with our lives.

Looking at things logically extends to the onset of a panic attack. When I feel my heart rate increase and my fingers go all twitchy, when I was in my worst place, this would cause my panic attack to come on faster in a self perpetuating cycle that on the worst occasions resulted in me becoming incoherent and witnesses calling an ambulance. In one such example I'm told that when paramedics arrived I had to be restrained because I tried to fight them and escape. I have no recollection of that but believe it to be true because I trust the person that told me afterwards. Now, when I feel those early signs, I immediately get the conscious analysis going before I deteriorate to the point where I can't. What is triggering this? Why is it causing me to react this way? Am I contributing to it by imagining the worst? Do I need to extract myself from the situation or would that actually feed my anxiety demon? Etc.

Apart from pure mental aspects, the other thing that has helped me personally is study of impact of diet on mental wellbeing. Us amateur athletes tend to go in for the old high protein for muscle, carbs for energy type diet advice. Doing lots of reading up I've come to the conclusion that with the exception of those at the very top of their game, with entire teams of experts looking after them, most amateur athletes have terribly unbalanced diets. For a long time I fell into that group. But as I've worked on fixing my own issues my journey of research has had me looking at the diets of some of the healthiest groups from general population, as well as looking at how gut health controls the availability, or lack of, of key micronutrients and chemicals. It's old advice but so often overlooked. Balance is paramount. Those groups of people that scientists like to study to find out why they are so healthy all have something in common. They all eat good wholesome food and don't really obsess over their carb/protein/fat ratios. Of course I'm over simplifying. My point is that for me at least, relearning how to nurture gut health has, I believe, been as important in my journey as the purely mental aspect of rational conscious analysis.