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mental health mondays :: finger on the trigger

nothing to be afraid of...
it's likely that most of us are going to have a panic attack at some point. the unlucky few are going to get them regularly and those with some real karma to burn are going to have to deal with a life where seemingly random, often unimportant things, set their brains alight and spinning into their own private v.i.p. room of hell, likely for hours at a time.

panic attacks can and often do come out of nowhere, but for those who are prone, they are often brought on by triggers- some kind of external stimulus that causes the brain to launch into panic mode. dealing with triggers can be sort of like doing a very intricate scottish dance around very sharp swords- the process itself is stressful, even if you avoid getting hurt.

in understanding triggers, it's important to identify what they're not. for instance, they're not phobias. phobias are an irrational, debilitating fear of a particular thing. the difference is subtle, but important. like many people, i have a mild to moderate fear of heights. the last time i was at the c.n. tower, despite the fact that i knew the section of the floor in plexiglass was totally safe, i couldn't walk on it because i was too scared. i literally stood on the edge, unable to make myself move forward. but once i stepped back and stopped looking down, poof, problem solved. although i'd felt petrified moments earlier, as soon as the immediate source of my fear was removed, everything was fine. and i can think about heights without any harm because while i might be afraid, the thought of them doesn't cause my brain to amp itself up into a feedback loop of anxiety and dread.

IF YOU'RE NOT PANICKING YET, BY ALL MEANS, CONTINUE READING...



because of this, i can never look at a flute again
triggers for anxiety attacks are also not quite the same as causes, but they can be related. if i'm in a car accident and have a panic attack, the accident is a cause- something that immediately brought about my panicked state. but afterward, simply getting into a car might cause me to become anxious, to the point where i might not even be able to. thus the cause has become a trigger. in fact, this sort of situation is often how triggers start- the mind experiences something traumatic and the memory of that makes one fearful even when presented with similar circumstances to the original event. i haven't been in a car accident, but i did work for some time at a job where i was constantly under a lot of pressure- having to work very long days, having other employees or my boss call me at home on weekends, vacation, in the middle of the night. as a result, even after i left the job, i found it difficult to be in the metro station next to the office. even being on the train going through the station would make my heart race and my breathing go funny. the metro station hadn't played any part in my stressful work experience. it hadn't ruined my vacation. but it was something that i associated with the everyday reality of the place and therefore it could "put me back there" just being in that location. soldiers coming home from battle have this but much, much, much worse.

and sometimes, triggers are just kind of frustratingly random. to use another example from my life [don't i seem like one great, big mess now?], there's an album i used to own, and one track in particular, that seems to immediately set me off, like it's out to get me. i didn't ever love this album, although i didn't exactly object to it [i think my copy was given to me as a gift]. the track that bothered me did not feature in any frightening or horrifying event. the worst thing i can say about it was that i heard it too often, because for a while it was featured almost weekly on a radio show i admired. but over time, my brain would just go into some sort of upheaval as soon as i heard even a few notes. to the point where i got rid of my copy of the album because i couldn't relax knowing it was in my house. i don't know why it upset me and i never will. since i purged the album from my collection, i haven't heard it once and chances are i'll avoid hearing it for the rest of my days. [i have a compilation, also a gift, that has the track in question on it, also a gift, which i keep because i like some of the other things on it, but i haven't reached for it in a suspiciously long time.]

personally, it makes me anxious that this even exists
now, it's easy enough for me to avoid listening to something that functions as a trigger, especially since it's kind of obscure. others aren't so lucky. imagine that every time you went to cross a street, you started to become anxious that somehow, the light would never change and that the traffic wouldn't allow you to cross, effectively stranding you on the spot until you ran heedlessly to your death under someone's wheels or slowly starved. imagine that you started to feel that way every time you saw a traffic light, that your brain started to react in that way. yes, it's illogical, but panic isn't logical. it's one of the worst things your brain can do to itself, because, unlike in the wild, where mortal fear is a sign that you should do something like run very fast, in the modern world, our fears tend to stop us from doing anything, or cause us to do very stupid, even dangerous things. our brains haven't quite adapted to domestication yet.

in that case, you'd be spending your life either trying to avoid traffic lights or living with the panic. good luck either way.

for those of you thinking that dealing with a trigger is not like "facing your fear". it's not something you can overcome by being shown that it won't hurt you, because most of the time, you're at least partially aware that it's not going to hurt you anyway. i never once suspected that my "trigger album" was going to saw off my head while i slept, but that didn't stop the feelings of dread that something awful was about to happen.

what's worse is that your brain has a tendency to create patterns for itself, so that it will repeat past behaviours when placed in the same circumstances. most people have probably discovered that they fall asleep faster and sleep better when they're in the same position, on the same side of the bed. that's your brain getting in its comfort zone. if you just arrange everything the way it likes, it will oblige your body by going to sleep, which is what feels like the right thing to do. unfortunately, your brain also does that when it comes to anxiety attacks; it remembers that the last six times you were in a certain situation, it freaked out, so, put in that situation once again, it thinks that that is the appropriate response. which is extremely frustrating when it's absolutely the wrong thing to do. thanks, brain. and, of course, once you've started down the path of a panic attack- even when the trigger itself is no longer an issue [e.g., the song is over, the light turned green, etc.]- it generally means a steep descent into a dark pit of your own creation.

you'd be crazy NOT to be scared
this is very tricky stuff to treat. drugs like benzodiazepines can "head off" a panic attack in its early stages, but they're addictive and don't work on everybody. cognitive behavioural therapy has shown effectiveness in helping people deal with anxiety, including "de-programming" their brain as far as triggers are concerned. the process of therapy [and the cost, if it's not covered by your government or private health care plan] can be daunting, so some may decide that it's easier to just deal with the fact that certain things are going to make them anxious and do what they can to avoid spending a lot of time in those circumstances. 

one of the first keys, of course, is recognising that something is, in fact a trigger, because a lot of times it seems so unrelated to everything else that storms through your brain in the midst of an anxiety attack that you can miss its significance. this is one of the reasons why cognitive therapy relies on very honest, basic assessments of each step of the thought process, starting with what was going on when you started to feel uneasy.

i'll feel badly if i don't mention something about how i'm grossly oversimplifying this whole process. the workings of the brain are not like the reflex points on your knees. even when a pattern is established, there's no guarantee that it will repeat with any exactitude, or that it will repeat every time. but trying to observe a pattern and identifying how far back it goes can at least help in overcoming the perplexing irrationality and boundless complexity that sometimes besets us.

now, if you'll excuse me, all of this talk of anxiety is starting to make me tense.

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