What NOT to Say to Someone With Panic Disorder
Imagine this: you’re allergic to cats. You’ve just been exposed to cat dander and your eyes are a soggy, drippy red mess. You sneeze uncontrollably multiple times in a row. Your skin becomes itchy, red, and full of welts. You’re feeling pretty miserable.
A friend walks up to you.
“Hey, no worries,” he exclaims casually, “there’s nothing to be allergic to!”
“Sure there is — I’m allergic to cats,” you’d probably say.
“Nah,” says your friend, “just stop sneezing. You’ll be okay.”
“What?! I can’t just STOP sneezing on a dime,” you retort.
“Sure you can. There’s nothing wrong with you,” he insists.
“Uhm, care to explain these welts, then? And the red eyes? And the sneezing?!”
Sounds frustrating, doesn’t it? If you suffer from allergies, you know that a reaction to an allergen can produce a truly miserable day. And while panic disorder is no allergy, it produces its own unique brand of misery, too.
And that misery can be compounded by how others react to a panic attack. Hopefully, no one would ever tell an allergy sufferer to “just stop sneezing” or to “make those welts go away.” It would be ineffective and frustrating advice.
However, as a panic sufferer myself, I’ve received a lot of ineffective and frustrating advice over the past few years. Most of it is delivered sincerely, with the absolute best of intentions, from people whom I care about. So, it often hurts to let these people know that their advice isn’t helping (and perhaps is even making the panic attack worse!). It’s not easy. If you haven’t yet developed a thick enough skin to ignore the below advice (I sure haven’t!), please share the below tips with family and friends who care about you.
This post was inspired by this list of things you shouldn’t say to someone who is depressed.
You say: “Just calm down.”
We want to say: “Okay, HOW!?”
Let’s pick this one apart piece by piece. “Just” implies that the act of calming down is a simple one. It’s not. For someone in the midst of panic, calming down can be an extraordinarily difficult task. For you, it might be effortless; for those of us with panic disorder, it might involve medication, breathing exercises, distraction, rituals, positive self-talk and reassurance, and/or time.
The “calm down” part is also problematic in and of itself. If you don’t have any tools, you can’t build a house, right? Unless you can construct some tools from thin air, you’re out of luck. Likewise, if we don’t have any tools or techniques (like the breathing exercises mentioned above) that can help us to become calmer, we can’t “build” anything. We can’t construct a ladder that will allow us to climb our way out of a panic attack. And, the added stress of being unable to comply with a “calm down” request might compound our anxiety.
Better response: Can I help you calm down? Is there anything I can do?
You say: “Why can’t you just relax?”
We want to say: “It’s a bit more complicated than you think!”
During a panic attack, the following physiological changes can occur:
* increased heart rate
* adrenaline rushes
* shortness of breath
* heart palpitations
* numbing or tingling in hands/feet
It’s like trying to relax while you’re being chased by a wild animal. Or while you’re frantically trying to find your way out of a burning building. Put simply, our panic-filled bodies aren’t capable of turning off the fight-or-flight impulse on cue. We’re not equipped with a switch. Even a steadfast resolve to relax will probably only incite further frustration over the fact that our body is going haywire.
True story: during my very first biofeedback session, the practitioner hooked me up to a computer that measures anxiety via skin conductance (read: sweat), hand temperature, heart rate, and breathing rate. As soon as she said, “Okay, now try to relax!”, my anxiety level (as measured objectively by a computer) surged upward. This is common!
Better response: I’m here for you. What can I do to help you relax?
You say: “There’s nothing wrong with you.”
We want to say: “Oh yeah? Then why does it feel like I’m going to have a (insert-severe medical-condition-here)?”
Classic line, often delivered by well-intentioned close friends, family, and significant others. Sometimes, this sentiment could be helpful — but only if we’re fretting over the “Is this just panic, or is it a heart attack or a stroke!?” question. Otherwise, it’s usually an unhelpful phrase that makes us want to yell, “Yes! There IS something wrong with me at the moment! I’m panicking, and it’s terrifyingly uncomfortable! THAT is what’s wrong!”
Better response: This must be uncomfortable. Can I do anything to make it better?
You say: “Sit down.”
We want to say: “But sitting down makes me more anxious!”
Usually, sitting down is a relaxing activity. We sit down to eat, to watch television, and to read a good book — and all of those events are generally agreeable and soothing. However, merely assuming a seated position isn’t going to act as a panacea.
The panic response sends a rush of adrenaline into our bloodstream that compels us to either fight or flee. It makes us feel like we need to be hypervigilant in order to ensure our survival. If you were really being chased by a wild animal, for example, sitting down would do you no good. That’s why the impulse to stand upright and stay alert is so strong. Leave this one up to the panicker: if we feel more comfortable sitting down, help us to find a safe spot. If we need to pace or go for a walk in order to calm down, let us.
You say: “You’re overreacting!”
We want to say: “Thanks, Captain Obvious.”
While it may be true that our body and mind are in overdrive, we often feel like we cannot control these reactions. In the midst of a rapid heartbeat, a cascading series of negative thoughts, and an intense urge to escape, having someone inform us that we’re overreacting is not helpful. We’re often aware that our body and mind are overreacting, but we may not yet possess the skills to disengage our frantic nervous system.
Better response: If you want, I’ll wait here with you until this passes.
Even though the above statements aren’t helpful to hear during a panic attack, some might be more appropriate after the threat of imminent panic has passed. If you know someone with panic disorder and want to be a great support person for them, check out this guide.
If you’ve ever had a panic attack, what’s the most unhelpful thing you’ve heard from someone who is trying to help? Share your thoughts in the comments or find me on Twitter @summerberetsky.
Stay tuned for the second half of this list — based on your comments — later in the week.
Beretsky, S. (2010). What NOT to Say to Someone With Panic Disorder. Psych Central. Retrieved on July 30, 2015, from http://psychcentral.com/blog/archives/2010/09/07/what-not-to-say-to-someone-with-panic-disorder/