The Panic Pod

Driving is a responsibility that should be taken seriously, but what happens when the heightened sense of alertness for driving becomes a tense white-knuckle ride while battling one's own fear? In this episode, Josh and Ella discuss driving anxiety in the context of both post-traumatic incident driving and generalised anxiety disorder (i.e the fear of having a panic attack while driving). When was the last time you heard of someone losing control driving while having a panic attack? Although the fear of this is common, in reality the chances of it happening are extremely low compared to those who get into accidents related to factors like increased speed, impairment from drugs/alcohol, or from fatigue. Getting back behind the wheel after a long time away can be unnerving, but using graded exposure and a good helping of self-compassion, it is possible to overcome the irrational anxious feelings around driving.

Root causes of anxiety can be traumatic events that cause us to change our behaviour in response to triggers. A root cause may also be something very minor but calcified over time to seem much worse than the first “event” that set things off.

However, the idea that anxiety always has a narrative such as this is overused, and doesn’t help people who just want to untangle and understand their anxiety disorder. Sometimes anxiety does have a root cause, but when it doesn’t – which Josh says is the vast majority of the time – the “root cause” narrative doesn’t actually help a clients’ progress.

Using the analogy of a house fire as a panic episode, josh says “When a fire brigade is called, their aim is to put out a fire, and then maybe investigate how the fire started, but definitely not the other way around.”

This episode is funny and empowering. Some of the subject matter can be shocking for people with emetophobia, but ultimately the goal is graduation from exposure, as Kimberley will explain.

Emetophobia is a clinical term which describes an extreme fear around vomit or nausea. As Kimberley says, “nobody likes to vomit,” but this phobic behaviour can cause anxiety in people's lives which can present different behaviours. It can even stop someone from doing things they love for fear it might make them vomit or be around people who vomit. Even if this isn’t something you think you are affected by, have a listen to this episode and you might learn something new about anxiety through this interview with Kimberley Quinn.

Wondering about why we’re here, how planet Earth exists and how much of a miracle life is are normal thoughts for us to have from time to time. However, if you have existential anxiety, these thoughts can trigger an anxious response; sweaty palms, shallow breathing, tunnel vision, tinnitus, and other anxious behaviours.

For people with conventional anxiety, leaning into hard feelings is easier. When you’re in the midst of an anxiety disorder, you have to have a different approach. Being confident in the ability to mindfully detach from anxiety isn’t always available for people with GAD (generalised anxiety disorder). You have to be confident ruminating on those thoughts and know it won’t lead to a panic attack.

For some, the answer may be dismissing these intrusive thoughts with, “This is not the time to think about this. This is not the time to go down that hole.”

Picking the time and place to have existential conversations can help to dive into heavy topics as an anxious person. Welcoming those thoughts in versus feeling them as intrusive thoughts are very different experiences. We hope this episode helps you understand existential anxiety more!  Reach out to us at talk@thepanicroom.co.uk

In this episode, Joshua and Ella discuss when panic disorder is centred around the fear of developing a serious mental health problem. This is referred to as Mental Health Anxiety.

The pattern of mental health anxiety is the disorder of mental health anxiety. Seeing thoughts for what they are (mere, passing thoughts) and remembering that “What If”s can’t lead you towards further anxiety or depression are important things to note when one feels they are in a pattern of mental health anxiety (the fear of developing mental health problems).

Ella has a realisation when she says that the pattern that we fall into with mental health anxiety is doing something to compensate for the feeling of control that we desire. Sometimes we fabricate control which eventually drives us towards disorder.

Things we talked about:

It helps to remove yourself and re-centre for a moment before you start mentally justifying why you are anxious.

There’s a lot of wellness narrative around “listening to your body” but when we’re experiencing disordered anxiety then somatic experiencing isn’t easy. Say you’re at therapy and your therapist is trying to get you to notice what some subtle sensations in the body are telling you about how you feel talking about something. A chronically anxious person may have to respond with, “As much as I’m trying to do what you say, I’d like to experience my body when my anxious response isn’t firing at all cylinders with cortisol and adrenaline.”

Not trying to deter anyone from slowing down and listening to their body, this conversation between Ella and Josh attempts to unpick where “body scanning” and “mindfully assessing the body” are two very different activities for people with chronic anxiety - when the body is in a hyper-aroused state, body scanning (where one assesses their own physical comfort for harm) tends to replace a mindful examination of the internal sensations we all experience. Josh’s advice is to catch and notice your nervous compulsions before you try to notice other sensations in the body.

Things we talked about:

Dr. Clare Weeks Video: https://www.youtube.com/watch?v=h8Id8tkvdzc

Untangle Your Anxiety - by Joshua Fletcher and Dean Stott: https://www.amazon.co.uk/dp/B08YQM9SPY/ref=cm_sw_em_r_mt_dp_5T7W0A04NN4NGGDTX8QB

Unlike other types of anxiety responses, derealisation and depersonalisation are stress responses which can make you feel like you are having an out-of-body or not-fully-lucid experience. Since anxious responses affect both the mind and body, experiences vary from person-to-person or relate to the situation you’re in. They are a result of stress, hyperventilating, or over-breathing over a long period of time. When something triggers an anxious response, it makes blood flow attend to the large muscles of our body (think fight, flight, freeze response behaviour in animals). There is increased blood pressure in the brain and blood oxygen levels. Derealisation means things may feel and look weird, and you can recognise your environment but it doesn’t feel like you’re there. You might even feel off-balance or have temporary tinnitus. Depersonalisation is when you feel like you are in a dream. You may “hear” your own voice louder, and have existential thoughts. Both derealisation and depersonalisation are harmless though the feelings that arise from the body’s response can feel scary. Dissociation is a response to trauma. People with PTSD may dissociate when they feel like they are back in their traumatic situation. This reaction is our minds’ way of experiencing less trauma by blocking out the experience we find ourselves in, even if the situation is only triggering a memory. Dissociation may be when we have a flashback whether we want to or not.

As discussed in this episode, vasovagal syncope is a similar but different body response. Similar to a panic episode like derealisation, depersonalisation, or dissociation, vasovagal syncope can happen simply by being triggered by a conversation or image. In some circumstances it can also be triggered by dehydration or constipation, and it may cause people to faint. Unlike derealisation, depersonalisation, or dissociation, vasovagal syncope decreases blood pressure in the brain, opens blood vessels in the calves and lower body, and is unique in that it is triggered specifically by the sight or graphic description of blood or injury. If you feel like it is coming on, your only injury may come from fainting, so it is advised to sit down or stabilise yourself against a wall.

We hope you found this episode informative and encourage you to share it with a friend you know who has experienced a dramatic body response, especially if they are unsure what it was.

Could procrastination be a symptom of your anxiety? Is it really procrastination or a nagging feeling that's guilting you for not enjoying yourself when necessary? Did you ever consider that the disordered thinking that occurs when we’re anxious is because of the low level threat response occurring in our bodies?

Generalised Anxiety Disorder (or GAD) is the diagnosis of chronic anxiety. Every human on the planet has felt anxious, but anxiety disorder is when our threat response runs out of control like a faulty fire alarm. Having “I should…” thoughts or self-criticism can be healthy in small doses, but when that thinking gets out of control, it can just lead to more confusion. It’s not good to be self-sabotaging your decision making like a well-intentioned but overly critical family member. There are even times when the feeling of being in control of your life can become addictive, and the evidence is seen by our friends and family when darker behaviours like depression, addiction, over/under-spending, over/under-eating, or angry outbursts emerge. It doesn’t cease so long as we continue to validate an anxious response by responding to the feeling of being threatened. It can take some experimenting along your own personal journey to find what works for you among the long list of solutions: exercise, meditation, diet, medication, removing yourself from external situations like an abusive partner, friend, or family member, or changing your own habits with the help of a therapist. In this episode, Josh and Ella chat about Generalised Anxiety Disorder (GAD).

We mentioned:

Josh's dog represents the adrenal response by being hyper-vigilant for part of the discussion and completely tiring out by the end. This episode is about anticipatory anxiety! Have you ever been more tired out by the dread of doing something that scares you than the actual act of doing it? How can a smaller queue on a giant roller coaster be less scary than a long one in the eyes of someone who's scared to ride? If your wise mind knows that the cortisol and adrenaline are going to mess with you, then it's better to jump straight into “it” without giving yourself too much time to let those emotions destroy your confidence. Anticipatory anxiety is the stress that we feel when we have to do something that has stakes attached to it. Mix a little anticipatory anxiety with the ability to procrastinate, and the feeling of ”I don't want to leave this state of anticipation" becomes an addictive cocktail of worry. Hope isn’t far, in fact, in may have been in front of you the whole time, but with a little support and self-compassion, you can rip the plaster off and see what healing lies on the other side.

We’ve been posting our Instagram prompts for the end-of-year hashtag #itsjustanxiety to the Panic Pod Community since the 21st of December. Please go on and share your own answer to your instagram story for other listeners to read. Let’s help each other and share the knowledge we’ve gained about anxiety. 💪

Going into 2021, the world is going to look and feel a lot different. Even when we are aware of challenging nature of what we face, anxious feelings arise. When we haven’t done something that is moderately fearful for a long time, those anxious feelings can be even more escalated. We ask ourselves, “How do I prepare?” Anxiety’s whole purpose is to make you doubt - especially anticipatory anxiety, which is the particular anxiety that comes from knowing that a challenge is in our near future and doing what we can to prepare for it. When it’s been studied, anticipatory anxiety has been found to derive from a different place in the brain than performance anxiety. Many people remark after-the-fact that the anticipatory anxiety they felt before an event was worse (or made worse) than the anxiety that they felt in the act of doing something challenging (delivering a speech, during a performance review, traveling on an airplane, etc.) This is because anticipatory anxiety can still trigger a threat response: palms get sweaty, we disassociate, we can’t sleep, and we keep thinking about the threat. The primal parts of our brains haven’t grown in tandem with the rest of our brain. Therefore, judgement, disapproving looks, failure, or even the idea of a panic attack cause our bodies to respond as though the threat was as real as a lion. Defining what we are threatened by can help us not to feel so much anticipatory fear.

We are so grateful for your kind words, follows, and feedback! Keep in touch with us to know when we upload new episodes!

@thepanicpod on Instagram and Facebook

Ella is @ellaofthenet and Josh is @anxietyjosh

Starting out this week’s episode with a bit of slam poetry, Josh and Ella discuss anxious relapse. It’s a term that can evoke the feeling that anxiety is a vice that we fall back into or succumb to but, as we know, anxiety is not a wanted or enjoyable experience. On the other hand, we can consider anxiety an addiction to reassurance. It can manifest in our behaviour as safety behaviours: carrying first aid kits, emergency snacks, or other tools with us when we fear our anxiety will resurface, seeking out people that comfort us, or avoid things that challenge us. These are the compulsions that frame our anxiety. So long as we live in the loss of confidence in our ability to tolerate anxiety, we are still “in” anxiety, which is sometimes felt as a “relapse”. Ella’s background with addiction and recovery sheds a little light on how actually the stress of anxiety and the substance abuse cycle can link up to create a cycle of bad behaviour. Josh redefines “anxiety relapse” with a phrase that’s as self-compassionate as it is accurate about what’s actually happening to us.

We are so grateful for your kind words, follows, and feedback! Keep in touch with us to know when we upload new episodes!

When you have a panic episode, adrenaline floods the system in a way that was biologically developed to help our survival. As chronic anxiety sufferers know, this adrenal flood happens when there is no tangible threat around us, so it feels like a biological response that is "out of control". Cortisol is another hormone that makes us feel stressed, but it operates differently. Cortisol flows in the morning, which helps regulate our sleep schedule, but it is also a hormone scientists believe serves a greater self-regulatory purpose: it reduces the amount of adrenaline we need to produce in order to survive. It’s a stress response that helps us to guide our attention to potential threats around us. If this served a purpose in our primitive days as humans, it might have been the hormone which helped to remind us that the bears come out to eat at dusk, so we need to do our berry-picking and hunting beforehand, lest we become their food.

Now that you know cortisol’s role, you have the opportunity to use it in a way that feels balanced for you!

Note on the audio: Thank you listeners for putting up with the steady beeping that was coming from Ella’s side of the recording. New recording space caused some issues! We apologise if it annoyed you throughout the episode, but we have resolved the issue for episode 25 and onwards!

We are so grateful for your kind words, follows, and feedback! Keep in touch with us to know when we upload new episodes!

@thepanicpod on Instagram and Facebook

Catastrophic Thinking is when we consider the spectrum of possibilities that can result from an event and believe in the most drastic, negative outcome. This pattern of thinking can affect our behaviour over time. That’s when anxiety starts to really affect us negatively. Hearing “your behaviour is the problem” when you’ve suffered an anxious episode is probably the last thing an anxious person can cope with hearing, but as Josh illustrates, these small acts of bravery - changing our behaviour in spite of our anxiety - can help to remind us what we’re capable of, and slowly re-pattern the anxious thought patterns we have grown accustomed to.

Note on the audio: Thank you listeners for putting up with the steady beeping that was coming from Ella’s side of the recording. New recording space caused some issues! We apologise if it annoyed you throughout the episode, but we have resolved the issue for episode 25 and onwards!

We are so grateful for your kind words, follows, and feedback! Keep in touch with us to know when we upload new episodes!

Self-discipline is something many people wish they had more of, but from Josh and Ella’s experience, people who have tenacious self-discipline can experience anxiety when their inner monologue gets drunk on power and outweighs self-compassion. When we condition our minds into using self-discipline to be productive and achieving results, we must also remember to balance that with moments of pause, reflection, and giving ourselves praise for accomplishments.

Sometimes people don’t like being nice to themselves. Sometimes people don’t know how to accept praise. Anxiety doesn’t manifest in a void. It feeds off of insecurity and trauma that hasn't been assessed. By understanding and accepting ourselves, we create the space we need to reflect on where our anxiety came from. Put your recovery first.

We are so grateful for your kind words, follows, and feedback! Keep in touch with us to know when we upload new episodes!

@thepanicpod on Instagram and Facebook

Based on many questions we’ve received for the podcast, we wanted to put together an episode on recovery. Recovery from chronic anxiety, in essence, is when the frequent, unprovoked feelings anxiety are no longer part of a person’s day-to-day life. It does not, as some anxiety sufferers believe, mean that anxiety will forever disappear. The challenge those in recovery face is to be with anxiety while working on how to recover. This means, fundamentally, recognising symptoms of anxiety are not physically harmful or dangerous. While there are treatments that may reduce the effects of aspect of anxiety (e.g. physical sensations), there are three pillars that anxiety sufferers face, defined by Josh as:

1. Physical sensations

2. Intrusive thoughts and thought patterns

3. Feelings and emotions

Recovery is not eradicating anxiety completely. It is learning to accept anxiety with self compassion in order for the anxiety symptoms to gradually subside over time.

OCD is a widely recognised name but fairly misunderstood disorder. Obsessive Compulsive Disorder (OCD) can present itself in a variety of different ways including but not limited to; an anxiety about germs and bacteria, an attempt to align symmetry or order, a tendency to hoard belongings, a repetitive checking for safety from harm, or intrusive thoughts that cause unique physical behaviours. These are just some of the ways OCD can present itself. Unfortunately, in media and the way it's used in offhand language, many people will use the term "OCD" when they mean they are being meticulous or organised. These folks don’t know what it’s like living with the disorder. People who suffer from OCD often fear, “If I don’t complete this task or ritual, then something bad will/may happen”. This could be superstition about an external event, or an anxiety about how they’ll feel afterwards. In this episode, Josh and Ella discuss how this is related to anxiety using the Martin Seif and Sally Winston model of our “wise mind vs. false comfort” which we introduced in Episode 8.

If you want to learn more about Martin Seif and Sally Winston’s work, check out:

"Needing to Know for Sure: A CBT-Based Guide to Overcoming Compulsive Checking and Reassurance Seeking" by Martin Seif (PhD) & Sally Winston (PsyD)

In this episode of the Panic Pod, Ella has a conversation with Dr. Meg Van Deusen, a Seattle-based psychologist and author of the new book Stressed in the U.S.: 12 Tools to Tackle Anxiety, Loneliness, Tech Addiction and More. Through the stress of the Coronavirus pandemic, climate crisis related events, and state of racial inequality and the presidential election in the U.S., Dr. Van Deusen provides hope using tools that have come from practical experience as a therapist. Just a few of the many tools in her book are discussed in this interview against the backdrop of our present-day stresses.

Follow Meg Van Deusen on social media or learn more about her at:

Josh and Ella discuss what life is like to have chronic symptoms of anxiety. One of the most common symptoms is called derealisation. If you have derealisation, all it really means is you have a heightened blood oxygen level from hyperventilation and are experiencing a “fight or flight” response. As a result you get a feeling like you are slightly detached from reality. You may have experienced this yourself whether or not you have chronic anxiety, but perhaps felt aloof when you received some shocking news. Josh and Ella also weigh in on the topic with examples from their lives. Ella likes Midnight Gospel as an ex-stoner Canadian and Josh doesn’t, which is okay.

Have you ever found yourself thinking, “I am using excuses to make myself feel temporarily more comfortable,”? What about, “I fear deviating away from locations which are familiar to me,”? What happens when you reach the point of realising, “I am avoiding leaving the house”?

In this episode, we discuss agoraphobia. Agoraphobia is defined in the dictionary as 'a fear of open or crowded spaces’. However, as Josh explains, it can be defined in a more nuanced way to identify what the trigger of panic is. As with other manifestations of anxiety, it’s important to remember that panic is harmless. It’s scary, but feeling it won't hurt you. Furthermore, Josh explains the idea of exposure: if you go towards what panics you, it disappears.

Books we talked about:

If someone you knew was experiencing anxiety, how would you calm and reassure them? For many of us, this comes easily. Having compassion and empathy for others is something we do every day. However, when we look at how often we use the same empathic listening on ourselves for our anxiety, it can be hard to find the same amount of compassion. Perhaps then, self-compassion deserves more space in our personal struggle with anxiety. How can we go about achieving this? Ella and Josh discuss the proactive and reactive nature of caring for oneself and some things we can do to manage our inner critic.

Some books we talked about in the podcast that will help you if you’re interested in learning more about self-compassion:

Kristen Neff - Self-Compassion

Brene Brown - Daring Greatly

Paul Gilbert - Compassion Focused Therapy

Chris Irons & Elaine Beaumont - The Compassionate Mind Workbook: A step-by-step guide to developing your compassionate self

Following up from our last episode on Imposter Syndrome, this episode has Josh explain a facet of anxiety that was studied extensively by the American psychologist Carl Rogers. Conditions of Worth is a lens in which to look through at threats to self esteem. If you feel as though you have a list of conditions you must meet in order to be a good person, these are your conditions of self worth. Society imposes some of these ideas that we all abide by, but sometimes the conditions of worth we have for ourselves are unique, or perhaps even wildly unrealistic for any person to achieve. Learn about introjection, self-compassion, and why therapists explore genealogical relationships in counselling.

Just because you have a feeling or a worry that you got where you are on chance, doesn’t make it true. Imposter Syndrome is the anxious feeling that we are somewhere we don’t belong. This is usually accompanied by feeling like we are not qualified or cool enough for the professional or social environment we find ourselves in.

Josh helps Ella illuminate what our wise mind already knows: not every day is going to be 100%. Perfection isn’t possible, but when we only see everyone’s celebrations of their greatest accomplishments, we often get a false sense of reality. Thereafter, we compare ourselves to that image of constant perfection, instead of recognising our humanity. When we chase the “What If…” of anxiety down the rabbit hole, we realise what lies at the heart of this particular manifestation of anxiety; a variable so paper-thin you’d think it really was made in our imagination.

What we talk about:

The Art of Being Yourself by Caroline McHugh - Tedx Talk

The Repeat Beat Poet (a.k.a PJ) is a friend of Ella’s from the London spoken word/live music scene. Ella often times reaches out to PJ for advice, as he is a performer with a crazy schedule who always seems to keep his work in balance with his own mental health. After many frank conversations about how to keep passion and play in line as independent artists, this is Ella and Repeat Beat’s first recorded discussion aiming to shed light on the topic. The conversation is for anyone who struggles with overworking or swinging between apathy and fits of passion for what they do to make a living.

We’ll be back next week with a normal episode between Joshua and Ella.

Repeat Beat Poet:

“The worst part about Coronavirus is worrying about getting Coronavirus,” but yet we see friends living through it, and others who are immunocompromised facing it fearlessly, so how can people with anxiety cope in this time of isolation and fear? Josh and Ella have a follow up to Episode 9: Health Anxiety in which the unprecedented nature of Coronavirus’s effect on society is discussed. Ella follows a model provided by Josh for assessing thought patterns triggered by health anxiety. Josh shares strategies for helping your own mental health, as well as making the environment you share with others a positive one.

Things we talked about:

Vicious Flower Model

What does social anxiety make you think of? For Ella, it’s parties. For others, it’s sometimes broader regarding identity and how other people’s opinions may threaten our identity. If you’ve ever had an excited or anxious anticipation of what someone’s text reply is going to be, it doesn’t necessarily mean you have social anxiety, but you know the feeling that someone with chronic social anxiety experiences on a regular basis.

Content Warning: We discuss the COVID-19 epidemic on the day that the WHO classified it as a pandemic (March 11th) so some things have come to light about the severity of the disease which we didn’t know on the day of recording. Please keep this in mind as you listen. We have a follow-up episode talking about the Coronavirus coming up in two more episodes. Stay strong, and stay tuned.

Two episodes on the same day! We're here to help you through social distancing.

Health Anxiety, or "hypochondria", is the chronic and persistent anxiety about ones' health. How does health anxiety affect those with it on a daily basis? Can you use Exposure Therapy to change your reaction to the Coronavirus from panic to boredom? 

Content Warning: Pedophilia, Violence, Suicide

Having the ability to let a thought pass through your mind without getting attached to it is one of the most frequent human experiences. Thoughts don’t define us like actions do, but when present in an anxious brain, thoughts can become persistent and intrusive. Josh explains what he does to manage his clients' worries when it comes to intrusive thoughts. By exploring "false comfort" vs. "letting go of the thoughts", intrusive thoughts can be viewed as nothing more serious than a song stuck in one’s head.

The book Josh mentions is:

"Needing to Know for Sure: A CBT-Based Guide to Overcoming Compulsive Checking and Reassurance Seeking" by Martin Seif (PhD) & Sally Winston (PsyD)