Nervousness / Anxiety / Panic:

Nervousness / Anxiety / Panic: First ask yourself some questions…

• Is your worry related to and an appropriate reaction to real life events or is it there regardless of whether life is going well or not?
• Have you found that you are having trouble concentrating or making decisions because of constant apprehension?
• Do you struggle with bouts of fatigue, insomnia or muscle tension due to feeling “keyed up” or on edge?
• Ever find yourself having periods of time where you feel as though you are losing control or like something is terribly wrong that last for several minutes?

Definition: First, nervousness, anxiety and panic are not the same thing. Nervousness is a very human and important emotion that can happen following an event or a difficult period of time in your life. If it lasts and starts impacting other parts of your life (i.e., work, relationships, etc.) this is when anxiety may be the cause. Panic tends to be both a feeling associated with anxiety but also can progress to a heightened “attack” representing more acute symptoms. This tab can be used to help you identify if you may have an issue that could be addressed.

Signs (i.e. what may be observed by others) and Symptoms (i.e. what is reported by firefighter).

• Feeling nervous for long periods of time without full relief.Feeling “chronically” powerless.
• Having a sense of impending doom or danger, this may or may not lead to panic.
• Having an increased or irregular (palpitations) heart rate.
• Finding yourself during times of worry breathing rapidly (hyperventilation).
• Waking up at night with cold sweats and worry.
• Finding your hands or body trembling when you are not cold.
• Feeling weak or tired often.
• Having trouble concentrating or thinking about anything other than whatever is your present worry.

Panic Attacks: Panic attacks are a progressed version of anxiety that manifests with a sudden feeling of terror. These episodes can occur at any time, even during sleep, and are often experienced with many physical symptoms. This is why many visits to the ER or emergency calls show no abnormal heart rhythm or elevated enzymes.

Example: Think of anxiety or panic as an alarm system. If you try to ignore what is going on, over time the “alarm” gets louder and louder until it creates symptoms. At this point you may be forced to deal with these feelings which can be overwhelming. Thankfully, both anxiety and panic are very treatable.

Other Issues to Consider:

There is a great deal of symptom cross over with medical issues:

Feelings of anxiety can be related to or caused by many medical disorders; a few examples are as follows:

• Heart disease and/or recent heart attack or surgery.
• Blood sugar level and/or Diabetes.
• Thyroid issues, such as hypothyroidism or hyperthyroidism.
• Asthma.
• Alcohol/Illicit Drug abuse or withdrawal.
• Side effects from medications.
• Irritable bowel syndrome.
• Rare tumors (pituitary/pancreatic, etc.) that produce certain “fight-or-flight” hormones.
• Premenstrual syndrome.
• B-12 deficiency.

Self-Help Goals:

Thought Goal: I’m nervous, anxious or panicky because I think… (Insert problematic thought here)… I can stop or lessen my nervousness, anxiety or panic by thinking… (i.e., About important upcoming events, your children, family or close friends, that these tough times will pass, I’m going to be ok, etc.).

Feeling Goal: I’m nervous, anxious or panicky because I feel… (Insert problematic feeling here)…. I can stop or lessen my nervousness, anxiety or panic by feeling… (More hopeful as you can handle difficulties and have done so in the past, supported when you reach out to your family or friends, etc.) .

Behavior Goal: I’m anxious or panicky because my behavior… (Insert problematic behavior here)…. I can stop or lessen my nervousness, anxiety or panic by behaving… (In ways that make you feel more like you (exercising, eating better, engaging with your loved ones, etc.), reaching out when you need someone to talk to, taking care of yourself through regular medical checkups etc.).

These goals are only examples; use them as guide not an absolute. You know if there is a problem, let now be the time to fix it.

Lastly:

Reaching out for help is never a sign of weakness, but rather one of strength. It may be intimating, annoying or frustrating to think about what to do and how to approach overcoming this, but it can be done. You do not have to do it alone. If you cannot reach or maintain all of these goals on your own, contact a peer supporter, medical provider and/or a psychology professional.

Written by: Cody Todd M.A., L.C.P.C. FPS Therapist