How to Handle Anxiety When It Hits You out of Nowhere

Have you ever experienced shortness of breath, racing thoughts, or feelings of absolute panic that seem to come out of nowhere? That’s what anxiety can look like, and it’s important to learn how to handle anxiety when it surprises you and threatens to ruin a perfectly good moment or day.

Anxiety disorders are the most commonly diagnosed mental disorders. They fall into several categories: panic disorder, social anxiety disorder, generalized anxiety disorder, and specific phobias.[1]

Panic disorder is commonly associated with a feeling of anxiety that hits you out of nowhere. These are often referred to as panic attacks. This article will teach you how to handle anxiety associated with panic disorder and panic attacks.

What Are the Warning Signs of a Panic Attack?

Panic disorder is characterized by sudden and unexpected panic attacks. Panic attacks may feel like they hit you out of nowhere. However, there are common warning signs, and learning to identify them is the first step in learning how to handle anxiety.

Here are the common symptoms associated with a panic attack:

  • Difficulty breathing or tightness in the chest
  • Heart palpitations or rapid heart beat
  • Sweating, shaking, or trembling limbs
  • Feeling dizzy, nauseous, or faint
  • Perceived loss of control or becoming detached from the body
  • Fear of death

What Causes Anxiety?

Anxiety can have many root causes, and knowing them can help learn how to handle anxiety in a more comprehensive way.

The Fight-or-Flight Response

While an anxiety attack may feel debilitating, it is actually the body’s natural response to danger. The fight-or-flight response is activated rapidly by the amygdala, which is the brain’s threat detection center. This response happens suddenly and without warning to help you respond quickly to danger.[2]

However, the system may become overactive when you have a history of trauma, an abundance of stress, or excessive fears about the future. Your brain may become hypersensitive to potential threats and detect danger everywhere. As a result, seemingly harmless objects, places, or people may trigger sudden and intense panic.

Conditioned Fear

Psychological studies have also determined that fear and anxiety may be conditioned. For example, pairing a neutral stimulus with a negative experience may lead to the neutral stimulus becoming associated with fear.[3]

Stated in simpler terms: a non-threatening situation, person, or object may become threatening after it is paired with anxiety.

For example, if you experience a panic attack while driving, you may start to associate driving with panic. As a result, driving may become a negative experience and general source of panic attacks.

Medical Conditions, Genetics, Stress, or Trauma

Anxiety may be the result of health conditions that mimic panic, such as heart arrhythmia or hyperthyroidism.[4] This speaks to the importance of meeting with a medical doctor at the onset of anxiety to rule out medical causes.

Genetics may also play a role in the development of anxiety. If you have a first-degree relative diagnosed with anxiety, you are 40% more likely to develop anxiety. Anxiety may also be the result of chemical imbalances in hormones such as serotonin, cortisol, or gamma-aminobutyric acid.[5]

Additionally, stress may play a major role in the development of anxiety disorders. You may be at an increased risk of developing an anxiety disorder if you have been exposed to catastrophic or ongoing stress.[6]

Lastly, anxiety is more common in individuals who have experienced Adverse Childhood Experiences (ACEs). ACEs include abuse, family challenges, and neglect. You can learn more about ACEs and find your personal ACE score on the Centers for Disease Control website.[7]

What Triggers Anxiety?

It may be frustrating to note that 53% of panic attacks occur in situations that are not threatening. The attack seems to hit out of nowhere. Alternately, the most common triggers for anxiety attacks in stressful situations are: work, driving, and shared public spaces.[8]

The crux of a panic disorder is that panic attacks lead to intense fears or avoidance of recurrent panic attacks. You may work yourself into a panic simply attempting to avoid experiencing panic. This can create a frustrating cycle if you don’t know how to handle anxiety and move away from panic when the first symptoms appear.

How to Handle Anxiety With Self-Help Techniques

Now that you have learned to identify the symptoms and causes of anxiety, you can begin to develop techniques to combat it.

Practice Diaphragmatic Breathing

One of the most common symptoms of anxiety is difficulty breathing. Shallow breathing can limit airflow and increase feelings of stress and anxiety.[9] Diaphragmatic breathing (also known as deep belly breathing) taps into the full capacity of the lungs while restoring a state of calm.

To practice diaphragmatic breathing:

Begin by placing one hand on the belly and the other on the chest. Attempt to send the breath into the lowest part of the lungs. You should feel your belly expanding on the inhale and contracting on the exhale.

If you notice your chest rises more than your stomach, attempt this lying down. If you still have difficulties, try breathing into a paper bag. Alternatively, you can slowly inhale through the nose and fully exhale through the mouth.[10]

Diaphragmatic breathing takes practice. It’s ok if it doesn’t work on the first attempt. It is also important to practice when you feel calm.

Develop a Mindfulness Practice

Mindfulness simply means present-moment awareness. Mindfulness practices have been shown to decrease symptoms of depression and anxiety. Mindfulness practices have also been linked with increased quality of life.[11]

Utilizing the five senses can be helpful if you are new to a mindfulness practice. One technique that focuses on the five senses is called grounding. It is a simple and quick method for returning to the present moment and regaining a sense of calm.

Try this grounding activity:

  • Notice 5 things you can see
  • Notice 4 things you can touch
  • Notice 3 things you can hear
  • Notice 2 things you can smell
  • Notice 1 thing you can taste

Repeat this activity as often as you like when learning how to handle anxiety. Think of grounding like a grown-up game of I-spy with the added benefit of increased calm.

Avoid Stimulants and Smoking

As you have learned, people with panic disorder are hyper-sensitive to bodily sensations that mimic panic. Stimulants may trigger the fight-or-flight response. Sources of stimulants include coffee, cold medicines, and some over-the-counter medications.[12]

Additionally, people with panic disorder are hyper-sensitive to breathing abnormalities. Smoking can restrict oxygen in the brain, which increases heart rate and may result in panic.[13]

Learn More About Anxiety

Bibliotherapy is often practiced along with therapeutic support. Bibliotherapy simply means reading self-help books as a complementary treatment.

The following list is an introduction to several helpful resources:

  • Don’t Panic (Third Edition): Taking Control of Panic Attacks by Reid Wilson, Ph.D.
  • Coping with Panic: A Drug-Free Approach to Dealing with Anxiety Attacks by George A. Clum
  • The Relaxation and Stress Reduction Workbook (Fifth Edition) by Martha Davis, Ph.D., Elizabeth R. Eshelman, MSW. & Matthew McKay, Ph.D.

Learn How to Handle Anxiety With the Help of an Expert

Only a licensed therapist, physician, or medical doctor has the authority to diagnose and treat a panic disorder. It may be helpful to visit an expert if you notice major changes in your behavior, thoughts, or mood as a result of anxiety.

Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy

(CBT) is commonly cited as the most effective treatment for anxiety. CBT can only be utilized by a trained professional and can be very helpful as you’re learning how to handle anxiety.

There are three components to CBT: Relaxation, Cognitive Restructuring, and Exposure Therapy.

1. Relaxation Techniques

Therapists may work with you to develop relaxation strategies. This may include working with your breath to create a sensation of relaxation. You will learn how to handle anxiety with coping skills, which you can utilize outside of therapy.

2. Cognitive Restructuring

Within CBT, you can expect to explore triggers for panic, including thoughts, events, or bodily cues. A technique called cognitive restructuring helps to replace negative thinking around panic with more realistic and positive thoughts.[14]

3. Exposure Therapy (ET)

There are two forms of ET that are commonly practiced as you’re learning how to handle anxiety:

The first form of ET involves environmental exposure to panic-inducing situations. This is called in-vivo exposure.[15]

The second form of ET involves exposure to physical symptoms of panic. This is called interoceptive exposure.[16]

Working Through Therapy Anxiety

It is common to feel nervous about visiting a therapist. In fact, some people may experience increased panic symptoms at the mention of therapy. It may be helpful to practice self-help techniques before you attend your first session.

Many therapists are offering services online as a result of the Covid-19 pandemic. Studies have shown internet-based CBT is as effective as in-person CBT.[17] Online alternatives may also be helpful for people with limited mobility due to panic disorder with agoraphobia (fear of crowds, leaving the home, or entering a scenario where escape is difficult).

Final Thoughts

It is important to educate yourself on the warning signs, triggers, and causes of a panic disorder or panic attack. Anxiety can be frustrating to live with day in and day out, but it is possible to learn how to handle anxiety and live a calmer, more focused life.

You do not have to suffer in silence or live a limited life. There is a solution for your suffering whether you choose to start with self-help techniques or seek therapy. The most important thing is to simply get started on your path to healing.

More Tips on Handling Anxiety

  • This Is The Real Life People With Anxiety Experience Every Day
  • The 20-Minute Morning Routine That Relieves Anxiety
  • How to Practice Mindful Meditation for Anxiety (Step-by-Step Guide)

Reference

Dialogues in Clinical Neuroscience: Treatment of Anxiety Disorders
Harvard Health Publishing: Generalized Anxiety Disorder
Dialogues in Clinical Neuroscience: The Biology of Fear- and Anxiety-Related Behaviors
Pharmacy and Therapeutics: Current Diagnosis and Treatment of Anxiety Disorders
Stat Pearls: Panic Disorder
Pharmacy and Therapeutics: Current Diagnosis and Treatment of Anxiety Disorders
CDC: About the CDC- Kaiser ACE Study
Neuroscience Biobehavioral Review: Etiology, Triggers and Neurochemical Circuits Associated with Unexpected, Expected and Laboratory-Induced Panic Attacks
Harvard Health Publishing: Relaxation Techniques: Breath Control Helps Quell Errant Stress Response
FRAN K M. DATTILIO , Ph.D. : Crisis Intervention Techniques for Panic Disorder
Trends in Psychiatry and Psychotherapy: Mindfulness in Mood and Anxiety Disorders: A Review of the Literature
Harvard Health Publishing: Combination Therapy for Panic Disorder
Harvard Health Publishing: Combination Therapy for Panic Disorder
American Psychological Association: Answers to Your Questions About Panic Disorder
BMC Psychiatry: Interoceptive Hypersensitivity and Interoceptive Exposure in Patients with Panic Disorder: Specificity and Effectiveness
BMC Psychiatry: Interoceptive Hypersensitivity and Interoceptive Exposure in Patients with Panic Disorder: Specificity and Effectiveness
Cureus: The Effectiveness of Internet Based Cognitive Behavioral Therapy

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If you suffer from depression or suddenly experience bouts of sadness that seem to come out of nowhere, you probably wonder why this is happening. The truth is that there are several possibilities, and you aren’t alone. According to the World Health Organization, in January of 2020, more than 264 million people were diagnosed with depression and is the leading cause of disability worldwide.[1] In this article, I will answer the question: why am I depressed if my life is fine?” I will discuss what depression is and what the possible causes of depression are. Additionally, I will offer some solutions to consider as you navigate the depression you are experiencing.

The question of why you are depressed if your life is fine is one that I can personally identify with, as I can remember a time when I went through an intense depression even though, in many ways, my life couldn’t have been much better. I was financially secure, had a good family, lived in a beautiful place, had a pretty adventurous and exciting life, but none of that could have prevented a serious and prolonged battle with depression.

Given that you are here reading this article now, you will hopefully be able to identify the problem early and get the support you need to fend off any significant depressive episodes, as this can make a huge difference in your battle with depression.

Furthermore, you don’t have to live with depression! Despite the debilitating effects of depression, with the right treatment and support, it is also one of the more “curable” mental health disorders and you can overcome it.

What Is Depression?

Depression is a mood disorder characterized by feelings of sadness, guilt, worthlessness, hopelessness, irritability, and in the worst cases, despair and suicidality.

Depression from a clinical perspective is classified into a few distinctive categories, two of the more common categories are; major depression and dysthymia. According to the DSM 5, Diagnostic and Statistical Manual—which governs the diagnosis of psychiatric and mental health disorders—major depression is classified as experiencing five or more symptoms in the same two-week period and must include a loss in pleasure as well as a depressed mood most of the day, nearly every day.[2]

The criteria are:

  • Loss of pleasure or joy
  • Intense feelings of sadness and depressed mood most of the day, almost every day
  • Difficulty sleeping or disturbed sleep
  • Change in appetite (increased or decreased appetite) and a 5% change in body weight
  • Difficulty focusing, poor concentration
  • Psychomotor agitation or slowing down
  • Excessive fatigue
  • Feelings of worthlessness or guilt
  • Persistent thoughts of death, dying, and suicide

Dysthymia is an ongoing or persistent depressed mood for a period of two years where you feel sadness more days than not. It will include at least two of the following symptoms when depressed:

  • Poor appetite or overeating
  • Insomnia or hypersomnia (having more sleep than usual)
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration
  • Feeling of hopelessness

The above symptoms of dysthymia can coincide with the symptoms of major depression.

Causes of Depression

Depression happens for several reasons that I categorize into three: biology, environment, and situation. Depression also tends to occur in more sensitive people, tend to overthink, and get stuck in their thoughts, which—more times than not—are negative.

Biological causes of depression are related to how your body produces neurotransmitters that impact your moods, such as serotonin, norepinephrine, and dopamine. Some people might have a biological predisposition for depression and never experience any significant symptoms but when confronted with a challenging life situation, such as a loss or disappointment, it can send them into a tailspin of despondency and intense feelings of low and sad mood.

Depression caused by one’s environment is more about those you might have grown up with, your family, and your home environment, which could also be connected to heredity. Regardless of your biological predisposition, you learn how to handle challenges in life by observing those around you.

Adults, in particular, are role models for children and will likely deal with life in similar ways as to what they observed. For example, a child who grows up witnessing partner abuse between their parents is at increased risk of either being a victim or perpetrator of violence in an intimate relationship as an adult.[3]

Situational depression, as I mentioned above, can be seen as more of a cause-and-effect relationship. When you are confronted with a particular life challenge or change, such as job loss, geographic relocation, or family and financial stress, these situations can cause you to fall into a temporary or prolonged depression.

In some cases, depression can be a combination of all of the above.

Examples of Causes of Depression

Below are some examples of situations that might lead you to experience a prolonged period of depression.

Grief

The loss of a loved one, especially when sudden and traumatic, can bring about intense feelings of loss and sadness, which can lead to clinical depression. This includes the death of pets.

Medical Issue or Diagnosis

Being diagnosed with a medical issue, especially if chronic and progressive, is much like any other loss you might experience. It represents the loss of a life you had. Very often, there will need to be changes made in one’s life that will not allow for a lifestyle previously enjoyed.

A Feeling of Failure or Perceived Shortcomings

As I mentioned, people who experience depression tend to be sensitive and self-critical. You might be struggling with not getting a job promotion or failing to progress in the way you imagined for yourself, but this doesn’t mean that you are not progressing in some other way.

Sudden Life Change

Changes—even good changes and welcomed changes—are hard. Sometimes, these changes can have an impact on your role and status in society like marriage or parenthood, which are both wonderful changes yet fraught with many challenges and new social roles.

Feeling Trapped or With Limited Options

Having options is both a blessing and a curse. We know that the more options we have, the less happy we are and the more anxious we might tend to feel, wanting and needing to make the right decision. However, on the flip side, the idea that you don’t have any options can also lead to feeling trapped and feeling that your life circumstances are already written in stone.

Burnout

Job stress, being overworked and underpaid, or the lack of fulfillment in your profession can lead to depression, which might also coincide with the feeling of being trapped and feeling as though you don’t have many options in your life and career.

What Can You Do If You Experience Depression?

It may sometimes feel as though, out of nowhere, that you are hit with depression, and this is true for many people who have a biologically based depression. However, I would argue that whenever there is something like depression or anxiety—which are defense mechanisms—there is something in your life that is not 100% congruent with who you are and where your life is at or going.

This essentially means that it’s time to take a step back and reassess a few things in life. It doesn’t mean that you will be able to wright the ship entirely. However, you might be able to make some small changes that will help you feel more in control of your life and the direction that you are going in.

1. Consider Therapy

Therapy will help you take stock and think about what is happening in your life and where you might be able to make some changes. Needless to say, you will also have the support you need to embark on making those changes. It could also be a chance to identify what it is in your life that is causing the depression. A therapist can also help you connect to other supports that might help you as you work through this period in your life.

2. Group Support Network

Processing hurt and pain through the group experience is a powerful method of connecting with yourself and others who might be experiencing similar challenges. Part of the value of group experience is knowing that you are not alone and that you have support not just from professionals but also from other people just like you.

3. Self Assessment

Self-assessment involves assessing where you are in your life in relation to your life goals, your relationships, and the direction that you are headed. Maybe it is time to make a pivot and change course, which could be a very scary thing. Bringing this kind of information to therapy will be very valuable and will assist you in the therapeutic process.

4. Take Some Time Off

Taking some time off will be and can be helpful in many ways. If you are experiencing burnout, this will give you more time for self-care and help you give yourself a break. Moreover, taking a time off gives you more time to do some of the things I described above in therapy, group work, and self-assessment.

5. Are You Bored?

Sometimes, when we lack stimulation or work in a job for which we are overqualified, we might find ourselves feeling underutilized and as if we are not meeting our potential. This would, hopefully, come out in a self-assessment and could indicate the need to make a change in your work life.

Depression and Suicide

Depression is a serious mental health disorder. Thirty to seventy percent of deaths by suicide are attributed to major depression or bipolar disorder.[4] If you or someone you love is experiencing depression and expresses thoughts or statements about death and suicide, consult with your medical professional or mental health counselor. People who receive treatment for depression have an 80 to 90% rate of success from therapy and/or medication.

Suffice to say, if you get the treatment you need for depression, your chances of recovering skyrocket. Again, as I mentioned earlier, you don’t have to live with depression. Get the right treatment,[5] and you can have a whole new lease on life.

Final Thoughts

Depression is a mood disorder that is characterized by feelings of sadness for a long period of time. Many people throughout their lives will experience some depression in varying degrees. If you notice that what you are experiencing resembles any of what I have described above, please know that you can make changes and you can live a life free of depression. Getting help, support, and treatment is essential to addressing the depression or changes in your life that might need to be considered.

More Tips on Coping With Depression

  • 15 Simple (And Practical) Ways to Overcome Depression
  • 20 Things to Remember If You Love A Person With Depression

Reference

The World Health Organization: Depression
NCBI: The DSM-5: Classification and Criteria Changes
OASH: Office on women’s Health: Effects of domestic violence on children
Mental Health America: Suicide
Upside Down Flan: The Best Treatment for Depression

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