Panic attacks and traumatic stress may be helped with mindfulness psychotherapy

Stress blog pic







Panic attacks and traumatic stress may be helped with mindfulness psychotherapy

Sally* is a 50 year old woman who came to see me in Surry Hills after a month of having severe panic attacks. These started first thing in the morning. She experienced shortness of breath, tightness in her chest, racing heart, trembling hands and legs, nervous sensations in the belly, irregular breathing and a sense of suffocation and impending doom. Often there would be no trigger for these panic symptoms. They would be intense for around 30 mins then would persist in varying degrees all throughout the day.

These panic feelings were impacting her ability to work effectively and maintain a social life. Sally often thought during these panic attacks that she was “going crazy” and perhaps there was “something deeply wrong with her”.

Ordinarily, Sally was a highly competent, robust individual who had never really experienced any severe anxiety or panic symptoms. However, she had just been through a major life change – she had relocated to Sydney from overseas after leaving a highly traumatic and abusive relationship. This relationship involved experiences of feeling a combination of complete overwhelm, helplessness and fear. One of the coping strategies she had adopted was to “keep going and push through” with a focus on action- oriented outcomes.

There was also a past history of accumulated grief from her recent mother’s and her late husband’s deaths, which she admitted was still unprocessed within her. She was holding traumatic stress in her body.

Sally was interested in helping herself as much as she could. Although she came to see me as a GP, she did not want to use medication unless it was absolutely necessary; she preferred to turn to mindfulness psychotherapy to help her.

Mindfulness psychotherapy may be healing

Through our weekly sessions together, she learnt how to use mindfulness to slow things down and observe her internal experiences without getting completely hijacked by them. She learnt to build and discover resources within her body and mind that helped her panic symptoms. By understanding and learning how to calm her internal world Sally felt empowered to then begin processing and integrating her previous ‘undigested’ memories and feelings.

This process allowed her to make sense of what has been senseless before and to regard the feelings in her body as useful information rather than something to be avoided.

Sally now experiences significantly less anxiety. More importantly when the waves of anxiety do arise, Sally now can work with her internal states, rather than let them escalate into full-blown panic as it had before. Mindfulness psychotherapy has allowed her to witness her thoughts and feeling and get a gauge on how they impact on her body. By working directly with and navigating the information held within her body, Sally now draws upon “safe” places, both inside and outside the body to regulate her arousal and bring her back into the present moment.

She reports feeling less reactive and acting less automatically and can now make decisions based on choice.

How does mindfulness psychotherapy help panic attacks and traumatic stress?

Sally’s panic attacks were a reflection of traumatic stress stored and held within the body. As a whole, our bodies are highly intelligent systems, equipped for stress and even trauma. When there is a perceived threat, our bodies will instinctually activate our “flight/fight/freeze” mode to take action and respond to danger. This then leads to a complex biochemical cascade within our bodies that orients us for survival.

Ordinarily, we can usually cope with great stress for a period of time as long as it is temporary and/or we can make sense of what has happened to us. However, when we are faced with trauma, this survival response becomes frozen and our bodies are unable to discharge all the pent up energy. We keep re-living what has happened, even when there is no obvious threat – it’s like a bad tape that keeps playing over and over again, without an option to pause or stop. So by using mindfulness to slow down, we begin to examine more carefully what is happening and to take in new information that would otherwise have never been noticed or would have been dismissed. We learn to develop a new language for reporting on our own internal experiences and finally begin to get to know intimately our emotions, thoughts and beliefs that held us captive for so long.

* Name has been changed

This case study is for educational purposes only. Results may vary due to individual circumstances.

Dr Marie PaekGeneral Medical Practice, Mindfulness Psychotherapy

For more information see:

Dysbiosis and leaky gut

Dysbiosis and leaky gut

Dysbiosis and ‘leaky gut’: recurrent gastrointestinal infections compromise a young girl’s development.

Twelve year-old Jenny*, was brought to see me as an Integrative GP by her mother. Around a year prior, she had suffered a gastrointestinal illness with nausea, vomiting and diarrhoea. This had lasted approximately 3 days. Three months later, she had fainted at school then suffered another gastrointestinal type illness.

Dysbiosis and leaky gut

Since the initial illness she had failed to put on weight and had lost her appetite. She was always slim (her family being of a lean predisposition), but Jenny had started to lose significant weight during this time (3-4kg). She felt tired and unwell plus had poor concentration at school, and couldn’t achieve the sporting level that she had been able to achieve previously.

She had undertaken a panendoscopy which showed slight stomach inflammation. During the procedure, a biopsy for coeliac disease was taken and showed negative.

Some background to Jenny’s development of dysbiosis and leaky gut

Up to the time of her illness, Jenny was a normal child. She had been breastfed for 6 months. She had had glandular fever when she was 5 years old. Helicobacter pylori was found when she was just seven years of age. This had been treated with the usual antibiotics and she had been on a gluten-free, dairy-free diet since then.

Years ago, Jenny’s mother told me that she had worked on a vegetable farm, where sprays were used routinely. Jenny’s siblings were all healthy and thriving. All children had been vaccinated fully.

On examination Jenny weighed 26kg which put her below the third percentile on the weight-for-age scale. Her height was 146cm which placed her on the tenth percentile. All her body systems were normal.

Testing that showed the dysbiosis in detail

She was sent for specific blood tests and a very comprehensive stool test. Blood tests were normal. Her stool test showed Dientamoeba fragilis, a bowel parasite, as well as generally low good bacteria. It also showed fat alabsorption and protein maldigestion.

She was prescribed a protocol of antibiotics for 10 days, targeting the parasite. After this, she was feeling slightly improved but was still tired and had a poor appetite.

One month after the treatment, a further stool culture was taken and it showed no evidence of D. fragilis. Jenny was then started on some very specific probiotic strains, forms of fibre and nutrients that were soothing and healing to her leaky gut, and some digestive enzymes.

After another 2 months of treatment, Jenny’s weight had increased to 26.6kg. Because she was suffering some anxiety after being so unwell for so long, she was put on some specific nutrients for antioxidant and anti-inflammatory effects. This was later changed to a multivitamin with gastrointestinal healing amino acids specially formulated for her age group.

By another two weeks her appetite had improved and her weight had increased to 27.1kg. An intestinal permeability test showed gut hyper-permeability; a stool test showed continued low levels of good bacteria so her probiotics and supplements were all continued.

By 12 months post treatment, Jenny’s height was 154cm and weight was 31.1kg. She is now in high school, doing sports and eating well (mother has her on a very healthy diet!). She remains on her various supplements at present with no symptoms of dysbiosis and leaky gut.

*Name has been changed

This case study is for educational purposes only. Results may vary due to individual circumstances.

Case Study on Dysbiosis and leaky gut by:

Dr Mark RobertsonNutritional Medicine, Integrative GP, General Medical Practice, Wholistic Medical Centre