Bedtime Panic Attacks

It’s pretty common for people going through stressful periods to have panic attacks just as they fall asleep or even during sleep, after having managed anxiety successfully during the day. This is because our psychological defenses and coping strategies drop away as we fall asleep, leaving anxiety symptoms free to rise. This can result in anxiety dreams or even panic that wakes you up.

While there is no way to “erase” anxiety, allowing yourself to experience the anxiety in a safe, mindful way during waking hours can help to minimize bedtime panic attacks and allow you to sleep better.

Specifically: allowing yourself to feel the anxiety until it passes, while–for example–talking to a trusted friend or your therapist, journaling, or just crying, can be a relief.

Moderate cardio exercise can also help in that it uses up excess cortisol, which triggers panic attacks. (However, don’t exercise right before bedtime as that may wake up your system and lead to insomnia.)

Compassionate Acceptance of Mental Illness

While there are many aspects of mental illness or injury that we can usefully learn to manage and to cope with, we may still have feelings, reactions, thoughts, and behaviors we would rather not have.  We may have internalized harsh or destructive judgments about those symptoms.

It is useful to cultivate an attitude of compassionate acceptance not only for the struggles of others, but also for our own struggles. When we first realize just how many aspects of life have been affected by mental illness, it can be overwhelming. It is also a chance to forgive ourselves and remember that we do not have to do everything “right” to have value as a human being.

This very useful post describes some of the unexpected ways mental illness may show up in everyday life, in things that we often criticize in ourselves or others:

 

What To Do Until Your Therapy Appointment

Even when there is not an emergency situation, it can be hard to cope with crisis or distress while you are waiting for your appointment in a few days or weeks. But taking care of yourself as best you can until then will help a great deal.

Talk to friends / family members: Share your feelings and thoughts with someone you feel comfortable with and who cares for you.

Take a bath / shower: Taking a bath or shower can calm you down and soothe you.

Exercise / take a walk: Go outside or go to the gym to exercise and release the tension.

Write: Take some time to write about how you feel and how you make sense of things.

Practice relaxation techniques: Listen to a relaxation track on YouTube or similar, and follow the directions.

Eat healthfully: It is important to take care of your basic needs. Fueling your body with healthy food is one of them.

Practice meditation: There are many different kinds of meditation. One of the ways to practice meditation is to be still and observe the sensations in your body from head to toe. If troublesome thoughts come into your mind, be aware of them but let them go. Try the free guided sessions at Headspace if a structured approach works for you.

Breathe deeply: You can practice deep breathing in any setting. Try to inhale deep into your abdomen.

Get enough sleep: If you are tired you will not be able to think clearly. Sleeping 7-8 hours per night can rejuvenate you and help you think clearly. Practice meditation or take a bath to help with difficulties falling asleep.

Attend to your spiritual needs: During hard times, attending to your spiritual needs by attending or observing services, meeting with others, or praying may help to comfort you.

Set several small goals for the day and work on them: Focusing on one thing at a time will help keep you from feeling overwhelmed.

Structure your time: Re-evaluate your priorities. Time management isn’t just about “how much can I squeeze in” but rather “what can I let go of.” Include things that are meaningful and comforting for you, not just a bunch of obligations.

Accept help: When loved ones offer help, try accepting some instead of expecting to do everything on your own. Also, remind the anxious part of yourself that you are no longer helpless and you will take care of yourself.

 

– Dr. Liz

  • (Adapted from materials used at Michigan State University Counseling Center)
  • For additional practical self-care measures, try this helpful list!