Trying to overcome intense anxiety and agoraphobia after this last years craziness with covid. These barriers are all new to me. I need to learn how to feel comfortable in society again. Your informational videos helps. Thank you.
I'm so fed up of having panic attacks. I get them when i travel or out in public in busy spaces. I suddenly feel my legs buckle under me and convince myself I'm going to faint die and not be able to get home. I will literally start crying in public
As iam listening to your words i felt relieved and my hear rate reduced rapidly. Specially when you mentioned that its ok to go to gym even though my heart rate is already high
Just found your videos, they’re amazing !! Your videos are so clear, well prepared, summarised and full of information Thank you so much for all your hard work
I go periods of intense panic attacks every few years where there will be a time where I have nearly constant panic for several months and then they just go away for a few years. Crazy, just sick of having this and being in a constant state of panic 😞
Dr. Nader...your videos are always inspiring and I like your counter-intuitive approach to mental health issues. It's very fascinating. And I'm enjoying it.
Hi Jayde - thanks for your kind words. Much of CBT is counterintuitive until you understand what is going on and models of anxiety. With that understanding, it makes a lot of sense. Thanks for your support of the channel!
Thank you so much for your help. I wish I would have known all this years ago! This information is life changing... I now have hope.. again.. Thank you 🙂
Thank you , your videos are always so easy to understand . I’m just trying to learn because I love someone who has panic attacks. As you were talking I realized I could use this advice for my driving anxiety to lol. I avoid interstates 😬
Hi Tina - glad you found the video helpful. One of the things I love about CBT is that the skills are applicable and transferrable to different types of anxiety. You just need to recognize the patterns and similarities. Good luck!
Thanks!!! This makes a lot of sense. I’ve had panic attacks for 10 years and it’s hell. I’m going to try these. I haven’t heard of doing this before (interoceptive exposure). Just that I’m supposed to expose myself to toastmasters or something for my social anxiety. This sounds a lot more helpful.
Hi Teresa - best of luck with your efforts. You may also want to check out other videos I've done about panic, including more detailed information about interoceptive exposure: Panic and Panic Attacks: ua-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
Your explanations are amazing I’ve watched a million videos this is the best explanation. I have a question, my anxiety has been 24/7 so bad that when I do calm down being calm feels strange and can trigger anxiety! I’ve read other people share the same experience. It’s so terrible. Any advice? Also thank you thank you for these videos 🙏
Thank you for another helpful video. With regard to the "threshold" concept - I tend to feel panic as being more like an on/off switch. I can be generally relaxed and then certain triggers e.g. Driving will set off panic almost instantly
Hi Pete - you are correct. Panic attacks do tend to be like an on/off thing. The point of the threshold idea is that the more stress a person is experiencing, the closer they are to the threshold to trip a panic attack.
It's interesting how different fears come into play here. For me I'm afraid of anxiety lasting forever cause my anxiety will be very cyclic in nature. This is reinforced by two weeks to a month I spent in 2018 experiencing constant panic supported by your model of just thinking I was choking which in turn lead to another panic attack. And now I've lived for 4 1/2 years in constant depersonalization. I'm not sure how to overcome this fear cause for me it isn't this irrational thought process that I am choking or dying rather that I dont want to feel constant emotional pain which for the most part I do either in the form of depersonalization or a mix of depersonalization and intense anxiety
@@DrRamiNader I see where you're coming from about catastrophizing but I actually lived this and am living it. I haven't come down from depersonalization for 4 years and when I wasn't depersonalized I literally was panicking for 2 weeks straight it didn't end it isn't catastrophizing with all due respect.
@@chrismarklowitz1001 You may also benefit from getting on medication while also using cbt training. Neither one is a one size fits all, but together, they can change your life. I'm living proof of that.
Do you recommend seeing a CBT specialist? I’m a combat veteran with severe panic, PTSD and anxiety. What’s messed up is I’ve been out of the military for 12 years now. And the panic attacks started only 2 years ago. I think I also have some trauma from a bad divorce too. Im not depressed but I just wanna feel better/normal again
I have been dealing with panic disorder every day for the past two weeks now. The second I wake up I notice my breathing and freak out that my breathing isn't right. I hate it and at night it's the worst I dread going to sleep because I know it's going to be the same thing almost having a panic attack freaking out.
@@papirowley2795 yes it did I feel almost 100% better. The best thing that helped was reminding myself that I was ok and nothing is wrong with me and I’m not dying haha I’d be freaking out at night with anxiety felt like I was maybe goin to die but every morning I’d still wake up and realize wow I didn’t die last night I’m ok 😂 people mention breathing techniques and stuff but for me it was mentally telling myself “I’m ok there’s nothing wrong with you’re fine”. It took a while to realize ok nothing is going to happen to me. But trust me I know that feeling it’s the worst but I promise you it will get better😊
@@papirowley2795 it took a couple months to stop thinking about it 24/7 like a month and a half . But at the time I was convinced I would never feel the same which sometimes I pay attention to my heart beat but nothing crazy. Just keep reassuring yourself that you are not going to die you are fine and you keep waking up the next day it's all in our head. But i get though it's really hard at first.
It really helped me by going online like reddit groups with panic disorders that have the same situation and everyone pretty much reassures you it really helped me because it made me feel better that i wasn't alone.
A highly effective great way to overcome a panic attack is to reframe the perceived threat from fear into excitement both of these emotions are so similar that the brain is easily fooled into releasing positive hormones that help overcome the panic attack.
If a person can do that, it would be helpful as it breaks the fear of fear cycle. However, much harder to reframe something as exciting when you are terrified.
@@DrRamiNader seems to work for most people. you just have to embrace the worst case senario and reframe the worst case senario to allieviate the fear.
So helpful I've been doing this for about 3 weeks i know it takes alot of time and practice for them to get under control and be gone..its a daily struggle loves to bother me at night any suggestions?
Hi Lori - I have more videos about how to manage panic attacks coming up in the next few months, so keep an eye for those. One of the most common pieces of advice that I give my clients with panic attacks is to, as much as possible, not fight having a panic attack. To allow the panic attack to happen, with as little resistance as possible. The more they try not to have a panic attack, the more likely they are to have a panic attack. I know it's much easier said than done, but it can be quite effective.
What if I get most of all the sensations you talk about. Do I do all those exercises? OMG!! Coffee, you just nailed it. I drink coffee and boom! Who would have drinking coffee and experiencing those symptoms!
The interoceptive exposures work for the various physical sensations a person is trying to do exposure to. So if the person experiences a lot of these physical symptoms during a panic attack, then they can do gradual exposures to the physical symptoms one at a time.
Doctor, please answer. If I start smoking, it gives me an unpleasant feeling of panic. Is smoking itself bad for panic, or can I stop it by facing it and smoking and breaking the link of unpleasant feelings and panic even though I smoke? Don't panic In fact, my question is what is the border between reality and fantasy, where should we really be sure that what we are doing is bad for Pink, where should we be sure that we should do the work and change our thoughts by facing and not being afraid.
I m the one who is suffering from panic disorder from 9 months and taking medications ssri from last 9 months... how to handle too much fear... as I feel I am going to die, having heart attack... so many negative thoughts.... please suggest me through ur msg sir
If you haven't already, I'd encourage you to take a look at the other videos I've done about panic attacks and panic disorder: Panic and Panic Attacks: ua-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
Hi Dr, We know avoidance is a major problem with anxiety disorders. How about medicine dependance? I take Propranolol to stop physical symptoms of anxiety twice a day. However I feel mentally worse being on this medicine, and everytime I get close to the time when the propranolol is going to leave my system my anxiety skyrockets and I cannot relax even when sitting at home by myself. Is this a form of avoidance? As in I am avoiding being unmedicated by my propranolol and thus training my mind that I am in danger 24/7 without my dose? Id love to hear your thoughts.
There are a lot of things people do to avoid normal, non-dangerous physical sensations associated with anxiety, including taking certain medications, relaxation techniques, avoiding coffee and exercise etc. Now, these things aren't intrinsically bad, but it's when a person uses them to suppress physical sensations of anxiety because a person is afraid of those sensations, then that's a form of avoidance.
@@DrRamiNader That's exactly the boat I am in. What would you recommend? A gradual taper/exposure to being off the propranolol and a slow lowering of my dose? I feel like i am fighting a war against my own body now trying to suppress all physical sensations. Exercise has also been prone to stress me out as well as coffee, before it was just being in situations I couldn't avoid. But I feel like i am slowly losing ground. I appreciate your reply Dr, it can be hard to find advice or someone to talk to about these things.
It varies depending on the severity of symptoms, duration of the condition, if there are other conditions, how much work the person puts into doing their homework exercises. In ideal circumstances, notable improvement in panic disorder can be seen in about 2 months.
@@DrRamiNader I just started doing cbt about a month you're so kind to talk to I just had one at the park and I made myself bring it on more its more dizzy and nausea I get and sensations heart loves to race..At night time sleeping is the worst do u have any programs? Or email or Instagram to talk?
Please explain why we shouldn't use relaxation techniques during a panic attack or building up!!!!! Thats what i usually do it never helps. What does help??? Is there a way to make it stop? Medication ideas? How do i make them stop? I haven't had them for 15 years why is it all of a sudden happening!!😭😭😭😭😭
This video provides an explanation: ua-cam.com/video/VVudLksCbfo/v-deo.html The idea is to allow the physical sensations to be there and not fight them.
Sit with the fear and let yourself feel the symptoms knowing you won't die. It will train your brain to not be afraid next time and shorten the attack. Try smiling as well.
is there anyone got cured or just managing ? and when you say managing is that the same as coping and if im managing and coping how can i get back to my normal life please reply tnx
About a third of the population will have a panic attack in any one year period, so panic attacks are pretty common. So when I talk about managing the panic attacks, it's not to completely eliminate and prevent ever having another panic attack. It's more about limiting the severity and functional impact the the panic attacks have on a person's life.
@@DrRamiNader ok sir so your saying that we can eliminate panic disorder and not panic attack and if we react the right way to panic attack we will not have the panic disorder again?
This i s incorrect. Bringing down overall stress and tension does NOT mean it takes more to hit the panic threshold. So False. People can trigger from zero to 100% in milliseconds regardless of previously being in a very calm state even for weeks. And Exposure to the Trigger can further TRAUMATIZE and INGRAIN that this is, in fact, something to fear - so that's not the next step.
Avoidance is the main cause. I am suffering from last three years. I have to face my fear to stop my panic attacks.
You are correct - Avoidance is the main driver behind all anxiety.
How one goes not avoiding please help buddy
I can't control them they come hard and fast and last hrs or even days. Help please am scared
Trying to overcome intense anxiety and agoraphobia after this last years craziness with covid. These barriers are all new to me. I need to learn how to feel comfortable in society again. Your informational videos helps. Thank you.
Covid has certainly done a number of people's anxiety. I'm glad you are finding my videos useful. Thanks for supporting the channel.
I'm so fed up of having panic attacks. I get them when i travel or out in public in busy spaces. I suddenly feel my legs buckle under me and convince myself I'm going to faint die and not be able to get home. I will literally start crying in public
Thankyou doc❤ I pray for the wellness of every body going through this
Thank you for your caring and encouraging comment.
As iam listening to your words i felt relieved and my hear rate reduced rapidly. Specially when you mentioned that its ok to go to gym even though my heart rate is already high
Glad the video helped!
Just found your videos, they’re amazing !!
Your videos are so clear, well prepared, summarised and full of information
Thank you so much for all your hard work
You're welcome! Glad you have found the videos helpful. Thanks for supporting the channel!
Another great video Dr. Rami !! Thanks again.
Thanks Rick! I appreciate your always kind and encouraging words.
I go periods of intense panic attacks every few years where there will be a time where I have nearly constant panic for several months and then they just go away for a few years. Crazy, just sick of having this and being in a constant state of panic 😞
Your voice is relaxing and you make panic attacks seem simple . Thx for a very informative video.
You're very welcome. Thank you for your kind words.
Dr. Nader...your videos are always inspiring and I like your counter-intuitive approach to mental health issues. It's very fascinating. And I'm enjoying it.
Hi Jayde - thanks for your kind words. Much of CBT is counterintuitive until you understand what is going on and models of anxiety. With that understanding, it makes a lot of sense. Thanks for your support of the channel!
Thank you for your videos. They are so helpful.
Hi Kristin - you're welcome! Glad you are finding the videos helpful.
Thank you so much for your help. I wish I would have known all this years ago! This information is life changing... I now have hope.. again.. Thank you 🙂
Hi Jarah - you're very welcome. Glad you found it helpful!
Thank you , your videos are always so easy to understand . I’m just trying to learn because I love someone who has panic attacks. As you were talking I realized I could use this advice for my driving anxiety to lol. I avoid interstates 😬
Hi Tina - glad you found the video helpful. One of the things I love about CBT is that the skills are applicable and transferrable to different types of anxiety. You just need to recognize the patterns and similarities. Good luck!
Thanks!!! This makes a lot of sense. I’ve had panic attacks for 10 years and it’s hell. I’m going to try these. I haven’t heard of doing this before (interoceptive exposure). Just that I’m supposed to expose myself to toastmasters or something for my social anxiety. This sounds a lot more helpful.
Hi Teresa - best of luck with your efforts. You may also want to check out other videos I've done about panic, including more detailed information about interoceptive exposure: Panic and Panic Attacks: ua-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
I just want to say Thank you! it really helped. Thank You Thank You 🙏
Hi Muddassar - you are very welcome. I'm so glad you found the video helpful!
Thank you so much!
You're very welcome!
Please do more cbt videos. Thanks. Great videos
Hi Ramandeep - I have lots of CBT skills and tools information videos lined up, so please keep an eye out for them. Thanks for supporting the channel!
Your explanations are amazing I’ve watched a million videos this is the best explanation. I have a question, my anxiety has been 24/7 so bad that when I do calm down being calm feels strange and can trigger anxiety! I’ve read other people share the same experience. It’s so terrible. Any advice? Also thank you thank you for these videos 🙏
this really helped my write my final third year psychology essay on panic disorders :)
My hope was that these videos would serve many purposes :)
Thank you for another helpful video. With regard to the "threshold" concept - I tend to feel panic as being more like an on/off switch. I can be generally relaxed and then certain triggers e.g. Driving will set off panic almost instantly
Hi Pete - you are correct. Panic attacks do tend to be like an on/off thing. The point of the threshold idea is that the more stress a person is experiencing, the closer they are to the threshold to trip a panic attack.
It's interesting how different fears come into play here. For me I'm afraid of anxiety lasting forever cause my anxiety will be very cyclic in nature. This is reinforced by two weeks to a month I spent in 2018 experiencing constant panic supported by your model of just thinking I was choking which in turn lead to another panic attack. And now I've lived for 4 1/2 years in constant depersonalization. I'm not sure how to overcome this fear cause for me it isn't this irrational thought process that I am choking or dying rather that I dont want to feel constant emotional pain which for the most part I do either in the form of depersonalization or a mix of depersonalization and intense anxiety
Hi Chris, you may want to take a look at this video on catastrophizing: ua-cam.com/video/2nkvB8PxhsY/v-deo.html
@@DrRamiNader I see where you're coming from about catastrophizing but I actually lived this and am living it. I haven't come down from depersonalization for 4 years and when I wasn't depersonalized I literally was panicking for 2 weeks straight it didn't end it isn't catastrophizing with all due respect.
@@chrismarklowitz1001 You may also benefit from getting on medication while also using cbt training. Neither one is a one size fits all, but together, they can change your life. I'm living proof of that.
I wish I found your videos 6 months ago I think I could have nipped it in the bud and prevented this severe anxiety 😥
How would u get exposuree to fear of dying or health anxiety?
Grear video! But one question, how do you deal with a panic attack once you are already going through one?
Hi Victor - the idea is, as much as possible, to just let the panic attack happen. People shouldn't fight it, just let it come and go.
@@DrRamiNader thank you very much, thats what i do it just feels horrible hopefully they will never come back
Do you recommend seeing a CBT specialist? I’m a combat veteran with severe panic, PTSD and anxiety. What’s messed up is I’ve been out of the military for 12 years now. And the panic attacks started only 2 years ago. I think I also have some trauma from a bad divorce too. Im not depressed but I just wanna feel better/normal again
CBT is an evidence-based and effective treatment for panic, PTSD and anxiety.
I have been dealing with panic disorder every day for the past two weeks now. The second I wake up I notice my breathing and freak out that my breathing isn't right. I hate it and at night it's the worst I dread going to sleep because I know it's going to be the same thing almost having a panic attack freaking out.
That’s how I feel right now, did it get better?
@@papirowley2795 yes it did I feel almost 100% better. The best thing that helped was reminding myself that I was ok and nothing is wrong with me and I’m not dying haha I’d be freaking out at night with anxiety felt like I was maybe goin to die but every morning I’d still wake up and realize wow I didn’t die last night I’m ok 😂 people mention breathing techniques and stuff but for me it was mentally telling myself “I’m ok there’s nothing wrong with you’re fine”. It took a while to realize ok nothing is going to happen to me. But trust me I know that feeling it’s the worst but I promise you it will get better😊
@@mia_talapia1 that is very reassuring tysm, how long did it take you to recover?
@@papirowley2795 it took a couple months to stop thinking about it 24/7 like a month and a half . But at the time I was convinced I would never feel the same which sometimes I pay attention to my heart beat but nothing crazy. Just keep reassuring yourself that you are not going to die you are fine and you keep waking up the next day it's all in our head. But i get though it's really hard at first.
It really helped me by going online like reddit groups with panic disorders that have the same situation and everyone pretty much reassures you it really helped me because it made me feel better that i wasn't alone.
A highly effective great way to overcome a panic attack is to reframe the perceived threat from fear into excitement both of these emotions are so similar that the brain is easily fooled into releasing positive hormones that help overcome the panic attack.
If a person can do that, it would be helpful as it breaks the fear of fear cycle. However, much harder to reframe something as exciting when you are terrified.
@@DrRamiNader seems to work for most people. you just have to embrace the worst case senario and reframe the worst case senario to allieviate the fear.
@@100musicplaylists3pls pls help me
So helpful I've been doing this for about 3 weeks i know it takes alot of time and practice for them to get under control and be gone..its a daily struggle loves to bother me at night any suggestions?
Hi Lori - I have more videos about how to manage panic attacks coming up in the next few months, so keep an eye for those. One of the most common pieces of advice that I give my clients with panic attacks is to, as much as possible, not fight having a panic attack. To allow the panic attack to happen, with as little resistance as possible. The more they try not to have a panic attack, the more likely they are to have a panic attack. I know it's much easier said than done, but it can be quite effective.
@@DrRamiNader thank you I pray someday they are gone.
What if I get most of all the sensations you talk about. Do I do all those exercises? OMG!! Coffee, you just nailed it. I drink coffee and boom! Who would have drinking coffee and experiencing those symptoms!
The interoceptive exposures work for the various physical sensations a person is trying to do exposure to. So if the person experiences a lot of these physical symptoms during a panic attack, then they can do gradual exposures to the physical symptoms one at a time.
Sir .. I need your help.
Doctor, please answer. If I start smoking, it gives me an unpleasant feeling of panic. Is smoking itself bad for panic, or can I stop it by facing it and smoking and breaking the link of unpleasant feelings and panic even though I smoke? Don't panic
In fact, my question is what is the border between reality and fantasy, where should we really be sure that what we are doing is bad for Pink, where should we be sure that we should do the work and change our thoughts by facing and not being afraid.
Hi Dr. Rami .. how can I book a session with you if I am overseas? Is there an online website that we can use to book with you ?
Because I am licensed in BC, Canada, I can only provide psychological services to people who live here.
I m the one who is suffering from panic disorder from 9 months and taking medications ssri from last 9 months... how to handle too much fear... as I feel I am going to die, having heart attack... so many negative thoughts.... please suggest me through ur msg sir
If you haven't already, I'd encourage you to take a look at the other videos I've done about panic attacks and panic disorder: Panic and Panic Attacks: ua-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
Hi Dr,
We know avoidance is a major problem with anxiety disorders. How about medicine dependance?
I take Propranolol to stop physical symptoms of anxiety twice a day. However I feel mentally worse being on this medicine, and everytime I get close to the time when the propranolol is going to leave my system my anxiety skyrockets and I cannot relax even when sitting at home by myself.
Is this a form of avoidance? As in I am avoiding being unmedicated by my propranolol and thus training my mind that I am in danger 24/7 without my dose?
Id love to hear your thoughts.
There are a lot of things people do to avoid normal, non-dangerous physical sensations associated with anxiety, including taking certain medications, relaxation techniques, avoiding coffee and exercise etc. Now, these things aren't intrinsically bad, but it's when a person uses them to suppress physical sensations of anxiety because a person is afraid of those sensations, then that's a form of avoidance.
@@DrRamiNader That's exactly the boat I am in. What would you recommend? A gradual taper/exposure to being off the propranolol and a slow lowering of my dose? I feel like i am fighting a war against my own body now trying to suppress all physical sensations. Exercise has also been prone to stress me out as well as coffee, before it was just being in situations I couldn't avoid. But I feel like i am slowly losing ground.
I appreciate your reply Dr, it can be hard to find advice or someone to talk to about these things.
@Protectereli Sorry, but I can't provide individual advice online.
@@Protecterelihe can’t tell you that legally, but I recommend you see a doctor or PA and ask taut
How long does it usually take for cbt to work?
It varies depending on the severity of symptoms, duration of the condition, if there are other conditions, how much work the person puts into doing their homework exercises. In ideal circumstances, notable improvement in panic disorder can be seen in about 2 months.
@@DrRamiNader I just started doing cbt about a month you're so kind to talk to I just had one at the park and I made myself bring it on more its more dizzy and nausea I get and sensations heart loves to race..At night time sleeping is the worst do u have any programs? Or email or Instagram to talk?
Please explain why we shouldn't use relaxation techniques during a panic attack or building up!!!!! Thats what i usually do it never helps. What does help??? Is there a way to make it stop? Medication ideas? How do i make them stop? I haven't had them for 15 years why is it all of a sudden happening!!😭😭😭😭😭
This video provides an explanation: ua-cam.com/video/VVudLksCbfo/v-deo.html The idea is to allow the physical sensations to be there and not fight them.
Sit with the fear and let yourself feel the symptoms knowing you won't die. It will train your brain to not be afraid next time and shorten the attack. Try smiling as well.
If they could Tolerate these feelings/sensation in the first place they would never have gotten Panic Attacks.
Do you have a program CBT?
I have a series of CBT videos on panic coming up, so please keep an eye out for them.
@@DrRamiNader can't wait is it ok for me too drink caffeine?
@@loribiagini4016 Sorry Lori, but I'm not able to provide direct advice to people online.
is there anyone got cured or just managing ? and when you say managing is that the same as coping and if im managing and coping how can i get back to my normal life please reply tnx
About a third of the population will have a panic attack in any one year period, so panic attacks are pretty common. So when I talk about managing the panic attacks, it's not to completely eliminate and prevent ever having another panic attack. It's more about limiting the severity and functional impact the the panic attacks have on a person's life.
@@DrRamiNader ok sir so your saying that we can eliminate panic disorder and not panic attack and if we react the right way to panic attack we will not have the panic disorder again?
@@ciscoenzo6827 Exactly, there's a difference between panic attacks and panic disorder.
@@DrRamiNader thanks doc now i am very optimistic and journey to recovery
I wish you all the best.
This i s incorrect. Bringing down overall stress and tension does NOT mean it takes more to hit the panic threshold. So False. People can trigger from zero to 100% in milliseconds regardless of previously being in a very calm state even for weeks. And Exposure to the Trigger can further TRAUMATIZE and INGRAIN that this is, in fact, something to fear - so that's not the next step.
🤍🤍🤍🙏🙏🙏🙏