ASK THE ANXIETY SISTERS

I was walking in the mall with my new boyfriend when I got flushed, hot, and dizzy out of the blue. I had to get out of there as fast as possible because I thought I would pass out if I stayed in the mall. It was so embarrassing because I did not know what to say to my boyfriend. Why would I get a panic attack in the mall when I was not even feeling anxious? Now I am afraid to go back there! What do I do now?

First of all, it is great that you realized that what you experienced was a panic attack (which we like to refer to a spinning episode). Many of us spend a lot of time and money just to figure out that our physical symptoms are connected to anxiety. When you know that you are dealing with an anxiety disorder, you are well on the road to managing it.

Unfortunately, many anxiety sisters experience panic/spinning episodes in the most ordinary places (although, truth be told, we find malls a bit anxiety-provoking!) and at the most inconvenient times. When we view this from an evolutionary perspective it makes some sense. Before shopping malls existed, our ancient ancestors were living in precarious environments. At any time, a person could become the food court for a pack of saber-toothed tigers or woolly mammoths. Consequently, people during those times had to live in a state of constant vigilance if they wanted to survive. Human brains adapted quite well to sensing danger and immediately going into the fear response–preparing to fight or flee from predators. Although we do not need that level of hyper-vigilance anymore, our brains have not evolved as fast as the realities of the modern world.

To complicate things, those of us with anxiety have an even more sensitive fear response. The part of the brain responsible for assessing fear (the amygdala) seems to misfire, even when no danger is present. The mall, in particular, is full of sensory stimulation (sounds, smells, lights) and is a fairly enclosed space with few exits–all conditions that could easily cause our trigger-happy brains to perceive danger. This is a very long way of telling you that many, many anxiety sisters (including us) struggle in malls.

Many anxiety sisters have found that our worlds can quickly shrink (we call this Shrinking World Syndrome) as more places become off limits due to anxiety episodes. We do not want there to be places that are off limits for you so–and we don’t relish telling you this–you need to head back to the mall. We understand that this may set off a spinning episode so we want you to be prepared by putting together a Spin Kit. When you go back to the mall (Spin Kit in hand) aim to stay for 5 minutes or so.  Gradually increase the time you are there until you can tolerate an hour. If these steps are too difficult, you may want to get some help (e.g., therapy and/or meds).

Lastly, you mentioned that you have not discussed your anxiety disorder with your new beau. (It sounds like you are still in early days of the relationship.) We understand that it can be hard to disclose this struggle with a romantic partner. And we believe that you get to decide when and if you feel safe enough to confide in him. However, if the relationship continues, you may want to think about sharing your anxiety with him. Feel free to share our website with him so that he can learn about anxiety. He may, in fact, prove to be a wonderful support. If he is dismissive of your struggles or unkind…well this is also important to know (sooner rather than later).

Keep us posted as to your progress.

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