MHMon

#MHMon: How to Help Someone Having a Panic/Anxiety Attack or Meltdown

A couple of days ago on Twitter there was a post circulating about helping people with panic attacks that recommended hugging them.

This was quickly shut down by hundreds–if not thousands–of anxiety sufferers who all said the same thing: If I’m having a panic attack, touch me at your own peril.

It’s not that people with anxiety or other mental illness are inherently more violent than neurotypical people. In fact we are more likely to be the victims of assault* than the perpetrators.**

What causes panic attacks and meltdowns?

First of all, we need to look at what panic attacks and meltdowns actually are. Primarily, they are a response to extreme stress. This could be caused by a specific event (such as public speaking, the death of a loved one, a car accident, etc) or it could be the combined stress of days or even weeks.

Think of it like this: Every time you turn on your kitchen tap, be it to get a glass of water or fill a pan to make dinner, water goes into the the sink and then flows down the drain, right? Sometimes the drain might slow down a little–you get some leftover pasta caught on the strainer and it slows things down, but you just empty it out and proceed as normal. There’s someplace for that blockage to go. Maybe you need to run the garbage disposal if things get really backed up.

So, if the water is the stresses in our life, and that drain is how we deal with them–say by doing yoga, walking the dog, journaling, or whatever else you do to relieve stress–then that’s an example of how it works for neurotypical people. Sure, you might get the occasional block, but you can go on vacation or get a massage. You power through it, as my mom would say.

That’s not to say that neurotypical people don’t have anxiety attacks, because that can happen. But it’s usually the exception, not the rule.

But for people with anxiety, depression, and a host of other conditions, that drain doesn’t work correctly. We can try to use a strainer to keep things that shouldn’t go down the drain from backing things up, but our pipes fit together a little differently and we don’t have garbage disposals. Eventually there’s too much debris, and we just can’t handle it.

Water begins to fill the sink, and we can’t shut off the tap. We can try to clear the pipes manually, but often lack the tools to do so. As panic begins to set in, we reach for a plunger and then water goes everywhere. It splashes over the sides of the sink. It covers us head to toe. It’s all over the floor and the counter, and it just keeps coming.

What’s the difference between a panic attack and a meltdown?

In my experience, panic attacks and meltdowns are two sides of the same coin. Personally, I’m more likely to have the latter, but I believe I’m in the minority there.

According to Web MD, the symptoms of a  panic attack include:

  • Racing heart
  • Feeling weak, faint, or dizzy
  • Tingling or numbness in the hands and fingers
  • Sense of terror, or impending doom or death
  • Feeling sweaty or having chills
  • Chest pains
  • Breathing difficulties
  • Feeling a loss of control

In short, the “flight” response (as in fight or flight) has been activated, and you feel like you have to get out. Right now.

And this is why it’s so important not to touch someone without their consent when they are having one of these attacks.

They are in flight mode. Logic brain is no longer in control. Anxiety brain has the reins, and it is telling the person that they need to get out now because there is danger. So when you walk up to someone and randomly hug them–whether they know you or not–Anxiety brain sees that as a threat and reacts in self defense. This might mean pushing the “helper” away, or even striking them.

Or, it could activate the third and little recognized fight/flight response: freeze.

But we’ll get to that in a minute.

When someone has a meltdown, they have a lot of symptoms similar to a panic attack. For me, my heart feels like it’s beating harder and more irregular. It’s hard to breathe. I can’t concentrate. My hands start to shake and I can’t regulate my body temperature. I start to sob uncontrollably, so I can’t talk and it makes breathing even harder. I start to panic even more because I can’t control the crying, but I feel like I should. It’s humiliating to cry in public, but I can’t stop, and that makes me cry harder. My face gets red. I develop an intense headache. I curl into myself because I want to hide.

As I start to come out of it, I will try to function and do normal things, but I still won’t be able to stop crying.

Panic attacks and meltdowns can last anywhere from a few minutes to several hours. I think my longest was about 4 hours, and it took me about 2 days to recover.

So how do you help someone going through this?

The first thing to remember is that it’s NOT about you. It’s not about making you feel better. You might think it’s awkward to see someone having a panic attack or meltdown, but I promise it’s a thousand times worse for the person experiencing it. You need to make them comfortable first. It’s not just a matter of getting out of an uncomfortable situation. It’s a matter of their health and safety.

Do:

  1. If they have a safe person or object, bring them. This could be a family member who knows how to cope with the attack and makes them feel safe so they can start to relax, or something that they like to hug or squeeze or hold that provides calming sensory input.
    If they have a safe person, follow that person’s commands to help. If they tell you the best thing you can do is go away, then listen. Don’t insert yourself in the situation if you aren’t wanted; you’ll only make the person having the attack more uncomfortable.
  2. Make sure they are in a safe place and not, say, wandering in traffic. If you can’t physically get them to a safe place, try to create a safe place around them, and keep strangers away, especially if they aren’t medical professionals. Ideally, a quiet room that isn’t too bright is best.
  3. Ask them what they need. Get it for them if you can.
  4. Speak in calm, soothing tones.
  5. If they are nonverbal for whatever reason, here are the things I like to have on hand when I’m having a meltdown: water, a blanket or sweater, and a plushie or pillow to hug. My knitting also calms me down. Having a fidget of some kind also helps. For me it’s usually a pen and paper (or the knitting).
    Make these things available, but don’t shove them in the person’s face. Just let them know they are there for when they are ready.
  6. Let them know you are there for them, when they are ready.

Don’t:

  1. Don’t touch them without permission. This goes for hugging, patting on the shoulder, holding hands, etc. I don’t care if they are your best friend, your kid, or your spouse, or a total stranger. ASK BEFORE YOU TOUCH THEM.
  2. Don’t raise your voice or loom over them.
  3. Don’t tell them not to cry, that whatever the trigger was isn’t a big deal, or otherwise try to diminish what they are feeling or make them feel like they aren’t entitled to their own emotions. Remember, this isn’t about you and your comfort. I know when I’m having a meltdown, nothing makes me angrier than someone telling me not to cry, not to be upset, that I’m overreacting, etc.
  4. If you can find a way to make them laugh or redirect them, that can be very helpful. But please remember that every person is different, and the person having a panic attack is in a somewhat altered state of mind. Their sense of humor might not be what it normally is. Do NOT use them, their mental illness, or other people as the butt of your joke.

Panic attacks present differently for every person. For some people, frustration can be expressed as anger. This is normal, but if that person threatens your or themselves, or if the anxiety attack goes on for such a prolonged period that they become ill or are in danger, call for help.

Ideally, this would mean calling 911. Explain that you need an ambulance for a mentally ill person having a panic attack and explain the situation calmly. It may be necessary for you to intercede between authorities and the person having the panic attack and act as a sort of interpreter.

However, due to the current state of affairs in the US, I know this is not always possible. If you know who the person’s “safe person” is, call them.

Nothing is worse than trying to help someone, and having them be killed or injured because the people who were supposed to help didn’t understand or even try to understand.

Freeze Frame

Back to the freeze response I mentioned earlier. This is the “deer in the headlights” response. If you touch someone and feel them stiffen or “freeze” then your touch is not welcome. This is why you need to ask first, and it doesn’t matter who the person is or what their state of mind is. Unsolicited touching in any capacity is never okay.

Sometimes the “freeze” response can go further, and instead of a panic attack you get the opposite: a total shutdown. But that is a topic for another blog.

Conclusion

I hope this helped you understand anxiety attacks and meltdowns a little better, and has given you better ways of coping with your own anxiety/stress or someone in your life. About 1.7% of people in the US has a diagnosed panic disorder of some kind, but at least 5% of American adults will have at least one panic attack in their life (personally, I think that number is significantly higher, but a large number of panic attacks go unreported especially in people with no diagnosis).

Have you ever had a panic attack or meltdown? How did you cope with it? Did you wish it had been handled differently, especially by those around you? Did your experience differ from those listed above? What is your preferred method for handling the situation? Leave a comment to let me know!

 


*https://www.mentalhealth.gov/basics/mental-health-myths-facts

**http://www.amhca.org/blogs/joel-miller/2017/10/03/gun-violence-and-mental-illnessmyths-and-evidence-based-facts


Like what you see? Check out Anxiety, Depression, and the Inability to Reach Out.

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