Helping Those Who are Suffering from Panic Attacks
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Yea, though I walk through the valley of the shadow of death, I will fear no evil; For You are with me; Your rod and Your staff, they comfort me (Ps 23:4)
Surely goodness and mercy shall follow me All the days of my life; And I will dwell in the house of the Lord Forever. (Ps 23:6)
Be merciful to me, O God, for man would swallow me up; Fighting all day he oppresses me. My enemies would hound me all day, For there are many who fight against me, O Most High. Whenever I am afraid, I will trust in You. In God (I will praise His word), In God I have put my trust; I will not fear. What can flesh do to me? (Ps 56:1–4)
God is our refuge and strength, A very present help in trouble. Therefore we will not fear, Even though the earth be removed, And though the mountains be carried into the midst of the sea; Though its waters roar and be troubled, Though the mountains shake with its swelling. (Ps 46:1–3)
The Lord of hosts is with us; The God of Jacob is our refuge. (Ps 46:7)
Be still, and know that I am God; I will be exalted among the nations, I will be exalted in the earth! The Lord of hosts is with us; The God of Jacob is our refuge. (Ps 46:10–11)
Introduction
Panic attacks (symptoms of extreme anxiety and/or fear) seem to begin suddenly, without warning. They can strike at any time — when you’re driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.
Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.
One of the worst things about panic attacks is the fear that you’ll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.
I would like to talk about panic attacks from two directions: how to deal with them when they come and how to live in such a way that they don’t come.
Symptoms
Panic attacks typically include some of these signs or symptoms:
- Rapid, pounding heart rate
- Sweating
- Trembling or shaking
- Shortness of breath or tightness in your throat
- Chills
- Hot flashes
- Nausea
- Abdominal cramping
- Chest pain
- Headache
- Dizziness, lightheadedness or faintness
- Numbness or tingling sensation
- Sense of impending doom or danger
- Fear of loss of control or death
- Feeling of unreality or detachment
- The strong desire to run away or escape (whatever that means)
Help Right Now
- Stop and think. If you are driving, you should pull over as soon and as safely as you can. Notice what is happening. Remind yourself that this will be over soon. You just have to get through it. Stay calm, don’t panic. God is in it and he’s good.
- Think Biblically. God is good and he’s giving this experience to you because he loves you and wants you to be more like Jesus. This means that this event won’t last and God is good. Quote appropriate Scripture to yourself (Using Phil 4:8 make a list of these).
- Talk To God. Ask him to let the event pass quickly and that no will be hurt. Thank him for the things happening in your body. Thank him for thinking that this will give him glory and you Christ’s likeness. Pray for someone else.
- Talk To The Panic. Say to the panic, “be gone you feelings of fear and anxiousness. You aren’t’ wanted here, nor welcome, you aren’t helpful to me, get out of here, run away before Jesus comes and tears you apart. I’m busy doing other things: things helpful to the kingdom of God!” (Luther: Letters of Spiritual Counsel)
- Breathing slowly and deeply. These kinds of events can cause you to breathe very quickly, which makes both the mental and physical symptoms of a panic attack even worse. When you start to feel panicky, be sure to take slow, deep breaths to soothe your mind and body.
- Relax your muscles. Anxiety causes your entire body to tense up, so make a conscious effort to relax each muscle from your toes all the way up to your neck and face.
- Let Others Help You. If you need to leave a situation, do so or tell someone you need to leave. Don’t be afraid to ask for help. Allowing yourself to become more upset will not help if what you really need is to take a walk and be by yourself.
Identify What Is Happening Over All
Medical Causes. Examples of medical problems that can be linked to anxiety include:
- Overmuch Caffeine (250 mg/day). 500-900 mg in a cup of coffee.
- Heart disease
- Diabetes
- Thyroid problems, such as hyperthyroidism
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
- Drug misuse or withdrawal
- Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
- Chronic pain or irritable bowel syndrome
- Rare tumors that produce certain fight-or-flight hormones
- Sometimes anxiety can be a side effect of certain medications.
Sinful Causes. The panic/anxiety-producing process is fueled by future-oriented, catastrophic thinking… What could go wrong? What might happen? What might not happen? In this context, panic attacks are the body’s reaction to the kind of thinking that has forgotten that God has the whole world in his hands.
It is important therefore to remember that God has a very strong opinion about our thinking processes. He says, for example, when God came to Abraham in Gen 26 he said, “I am the God of your father Abraham; do not fear, for I amwith you.” In Philippians, Paul told folks who were undergoing persecution, “Be anxious for nothing” (Phil 4:6). And Jesus told the folks on the mountain top not to worry about money, food, or clothing because God loved them more than they knew (Mt 6:25-34). And there are lots of other places the Bible talks about fear, anxiety, and worry. When our concerns are, or show, a lack of trust in God and his provision, it is sinful.
With this in mind, unless the event is medically related, the person who is about to have a panic attack has forgotten that nothing happens or will happen that God is not totally in charge of. And he loves us. Therefore, we can trust him with our future.
It is also helpful to note that most of the time when God talks to us in our fear and anxiety, he comes to us in a gentle and kind way. He comes to rescue us from our fears. He comes to a lamb caught in a thicket, not like a raging warrior trying to rip our heads off. “Be still and know that I am God” Ps 46:10). “do not fear, for I am with you” (Gen 26:24).
How to Help Long Term:
Talk to your friend.
Ask about the actual panic attack: How did it feel? Were there any warnings that it was coming? What actually happened? What did you think and do? How can I help now? It is often helpful to talk about the panic as if it is an actual entity, or event, outside the body rather than as something that is part of him. It was an event that he participated in rather than something that is him.
Ask about his history, about how he came to Christ, how he currently walks with Christ. Ask about his Bible study practices (noticing how often, how much, what the nature of the study is, and how he thinks about God while studying).
Ask about the immediate context of his life. Have things been hectic? How is his job going? Does he want to be married and isn’t? How are things going with his wife? His kids? Is he under a lot of stress?
As you are listening to your friend’s story, pay attention to the smaller events that are part of the story. If they are the kind of events where the person is suffering, note that. If they are the kind where the person has been victimized in some way, note that. And, if the person is sinning, even in or as a result of the suffering/victimization, note that as well.
It is important to sympathize with your friend. You can’t understand what he went through, you aren’t him, but you can give him support and godly comfort.
What support looks like: Hugs, loving care, kindness, etc.
What comfort looks like: it means pointing them to Christ. But not just a generic “Jesus loves you and wants you to be happy and not have these events in your life.”
Comfort means calling your friend to draw near and walk with God, to love him, to be grateful, to be joyful in his presence and activity in his life. Giving comfort, even when the person is sinning, still looks like pointing them to Christ.
Medical. This will look different if through listening to his story you realize that what is happening to him may not really be about panic, anxiety, or fear. If it is medical, you still want to help him draw near to God, but it will look different than it will if you need to counsel him through a sinful life. Study the Bible to see how people respond to suffering.
Sin. As I’ve said above, God loves your friend and wants to be in fellowship with him. He is calling to him and trying to calm him and reassure him that all will be well because God is present and has control of the situation. He doesn’t view him as a hateful rebel, but more as a lost sheep that has wandered of and gotten stuck in a whole. He comes to the anxious person in a kind and tender way, wanting to save him and restore him to sweet communion with the creator of the universe.
Yea, though I walk through the valley of the shadow of death, I will fear no evil; For You are with me; Your rod and Your staff, they comfort me (Ps 23:4)
Surely goodness and mercy shall follow me All the days of my life; And I will dwell in the house of the Lord Forever. (Ps 23:6)
“You will keep him in perfect peace, whose mind is stayed on You, because he trusts in You” (Is 26:3).
God is our refuge and strength, A very present help in trouble. Therefore we will not fear, Even though the earth be removed, And though the mountains be carried into the midst of the sea; Though its waters roar and be troubled, Though the mountains shake with its swelling. (Ps 46:1–3)
The Lord of hosts is with us; The God of Jacob is our refuge. (Ps 46:7)
Be still, and know that I am God; I will be exalted among the nations, I will be exalted in the earth! The Lord of hosts is with us; The God of Jacob is our refuge. (Ps 46:10–11)
One place we see this applied is in the life of Christ: “when He was reviled [by people], did not revile in return; when He suffered, He did not threaten, but committed Himself to Him who judges righteously” (1 Pet 2:23). Jesus believed that the Father loved him and would protect and rescue him.
We see this same sentiment when Jesus said, “Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest for your souls. For My yoke is easy and My burden is light” (Mt 11:28–30). There is a yoke and there is a burden, but when you are drawn near to the Father in heaven who loves you, it is easy and light.
Of course, if there is sin, confession and repentance need to occur. “If we confess our sins, He is faithful and just to forgive us our sins and to cleanse us from all unrighteousness” (1 Jn 1:9) is still true and needs to be observed. And now what? Where do we go from here?
I mentioned before, that Paul said not to be anxious, but what should we do instead? “but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus” (Php 4:6-7). Also, the next verses are helpful for someone who is battling with anxiety,
Finally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy—meditate on these things. The things which you learned and received and heard and saw in me, these do, and the God of peace will be with you. (Php 4:8–9)
Another answer or solution to anxiety and worry is “Seek first the Kingdom of God and his righteousness, and all these things will be added to you” (Mt. 6:33). With the next verse, “Therefore do not worry about tomorrow, for tomorrow will worry about its own things. Sufficient for the day is its own trouble” (Mt 6:34).
Counseling Homework
For homework, I might work through all the passages I’ve mentioned in this talk. I would add various Psalms like Psalm 27 that begins, The Lord is my light and my salvation; whom shall I fear? The Lord is the stronghold of my life; of whom shall I be afraid?…
I might ask the counselee to work through the 119th Psalm, paying attention the psalmist situation, his attitude toward God, all the while praying that God would give him the same delight in God’s word and in God that the writer has.
Going through Philippians is helpful. Paul is locked in a Roman prison and writing to a church that is going through persecution. In that letter, among other things he tells them to “rejoice in the Lord always.”
Applying Philippians 4:8 is helpful. I ask the folks to create lists of Paul’s list: “whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy—meditate on these things.”
Be merciful to me, O God, for man would swallow me up; Fighting all day he oppresses me. My enemies would hound me all day, For there are many who fight against me, O Most High. Whenever I am afraid, I will trust in You. In God (I will praise His word), In God I have put my trust; I will not fear. What can flesh do to me? (Ps 56:1–4).
Zeph. 3:14-17
Pss 42 & 43
Through the Lord’s mercies we are not consumed, Because His compassions fail not. They are new every morning; Great is Your faithfulness. “The Lord is my portion,” says my soul, “Therefore I hope in Him!” (Lam 3:22–24)
Conclusion
Panic attacks are the body’s response to stress, fear, worry, and anxiety. Our bodies might experience events like this as a result of medications or other physical things, but I would encourage you to not call those events Panic attacks. They are more like the suffering that comes naturally in a fallen world. If your panic or your friend’s panic attacks are a result of sinful fears and worries, we need to point them to the creator of the universe who loves them. This will bring them into sweet fellowship with God and also allow the body the freedom to repair itself and stop having the physiological response to the pressure.