The person who has experienced this frightening sequence of thoughts might start to try to avoid situations in which they fear they would be unable to contact a hospital if they had an unexpected heart attack. They may avoid camping trips with their families because they do not want to be out of range of a cell tower. They may avoid social settings with unfamiliar people because they are afraid that if they were to have a heart attack in front of people that they do not know and trust, no one would come to their aid, no one would call an ambulance, etc. Pretty soon, that person's panic attack has limited the range of things they are able to do with their time, and that person is no longer living the full life they would like to live. They are confined to familiar people, familiar settings, cities and urban areas, and a whole range of the human experience and the natural environment has become "off limits" to them. And all because of a panic attack. This is the kind of power that panic disorder can start to exert in one's life. Oftentimes, a panic event related to fear of death may be associated with - or triggered by - sensations within their body that people associate with danger. One example would be a heart arrhythmia - or a sudden change in one's heartbeat or pulse, which people associate with a feeling that one's heart has "skipped a beat." While arrhythmias can in some cases be signs of heart disease or other cardiac problems, they are also entirely normal and can be the result of things that are far less frightening and dangerous. For instance, sometimes failing to get enough sleep the night before can lead to an experience of arrhythmia. Drinking a lot of coffee or other caffeinated beverage can lead to it as well. Even eating a lot of potassium has been associated with the arrhythmia sensation. The reason we struggle to get our act together is because we're a bad influence on ourselves. We're rebelling against the rules and what we know is right. We're too lenient, too easy, and not holding ourselves accountable. Our inner-child is influencing our decisions. When you need to be strict on yourself and know exactly what needs to happen to reach each of your goals and hit your targets, the childish part of our mind doesn't like the boundaries and wants to bend and break the rules, rebel, and keep you from moving. "Go ahead and sleep in. You need it. You're not a robot." "You're hungry.

Fast food today won't matter. Enjoy yourself." "You're tired, skip the gym today. You deserve it." "One cigarette won't hurt. You're stressed. Take a load off." "Spend that money on whatever you want. Your bills can wait." You have to take the stairs to be successful. Stop looking for shortcuts and ways to be lazy. Stop being a bad influence. Stop rebelling. Stop bending and breaking the rules. Stop being a bad example. You can't be a bad influence on yourself and a good influence on others. Stop telling yourself the rules don't matter. Stop trying to go around them. Stop influencing, persuading, and convincing yourself to get off track. Stop listening to your inner-child that wants you to do things you shouldn't. Stop listening when it wants to set you back. Stop listening when it wants to indulge in addictions. Stop listening when it says you're too strict and too hard on yourself. It doesn't know what it's talking about.

When it starts talking, make it be quiet. Do I really believe someone thinks less of me as a result of what I have done and, if so, why? (Remember to use the skills you have learnt in the Anxiety-Free Thinking' section of this book.) Would I think less of someone who had gone through an identical experience? <a href=''>If</a> you have answeredno' to both questions why hold yourself responsible when you would not treat others the same way? So many people worry about every aspect of life. Anxiety, as we discussed earlier, is based on fear. Things go wrong and there will be times when you are worried. For example, if your partner had to have medical tests it would be normal for you to have some concern regarding outcome. The whole area of fear can be rated in terms of mild, moderate, or severe feelings. Mild fear could be seen as worry, whereas severe fear could be seen as extreme anxiety. If we stopped worrying this would not be helpful as a certain amount of worry makes you feel better. When you feel anxious it is useful to do some relaxation exercises. There are many forms of relaxation, as we discussed earlier. Some require physical movement while others require nothing more than breathing or visualization techniques. Listed below are three common relaxation techniques. Often relaxation exercises rely on you being able to make time to lie down or, at least, stop whatever it is that you are doing. This simple breathing exercise is one that you can do anywhere, any time, and no one need know you are doing it. This exercise can help you take the edge off your anxious feelings while reducing the negative effects of adrenaline, helping you maintain your calm. You will remember the breathing exercise in the early section of this book, which provides you with an effective technique to calm you down and help you remain in control. As this exercise is portable, given that you can do it anywhere at any time, it can be termed a 'life saver' as the more you use it the calmer you will feel.

As you breathe in and out, use your stomach muscles to control your breathing. When breathing in, use your stomach muscles to push out. When you breathe out, use your stomach muscles to push in. This way you breathe more deeply, which helps you gain maximum benefit from the exercise. People who experience anxiety often breathe shallowly. Shallow breathing means your body gets too much oxygen and many people are tempted to compensate by breathing faster. However, breathing too fast can make you feel dizzy or faint. This leads to a condition called hyperventilation. It took until 2009 to start to move toward the light, when President Barack Obama declared that the term War on Drugs was not useful and would not be used by his administration. His Office of National Drug Control Policy stated, in 2011, "Drug addiction is a disease that can be successfully prevented and treated." Yet, despite these indications of forward progress, crop control, border interdiction, and state and local drug raids and seizures continue to occur, wasting billions and billions of dollars nationally and globally. Our former president also commuted the sentences of well over one hundred people before he left office. This story was dramatized by Shruti Ganguly, one of the incredibly creative members of Fictionless, an Oscar-awarded documentary company. She directed five short films, each depicting the story of a man or woman who had been incarcerated for a nonviolent drug offense in the days of extreme mandatory sentencing. All five, two black men, two black women, and one white man, had their life or lengthy mandatory sentences commuted by President Obama, as part of his ongoing clemency for people whose punishment did not fit the crime, and who had spent most of their adult lives behind bars. Yet there is still so much more to be done, in and out of our prison system. We know that fiction can reveal many a truth. HBO's The Wire (2002-08) portrayed the fictitious but alarmingly real Baltimore drug world, offering a depiction of the prison pipeline for drug offenders. The series repeatedly showed a strategy called buy-bust, in which undercover police officers buy drugs from dealers and then bust them. Their targets were invariably black. Photo ops typically ensued after a police bust, often with the display of a folding table covered with plastic-wrapped bricks of drugs and an assortment of deadly weapons and cash.

So, if your heart misses a beat, it does not at all necessarily mean you are in danger. It might just mean that you recently ate a banana! Nonetheless, for people suffering from panic disorder and panic attacks, this commonplace and perfectly safe phenomenon of a mild arrhythmia can trigger very frightening thoughts of heart failure, which can lead in turn to another panic attack. Along similar lines, people with panic disorder may start to fear that their panic itself will lead to a heart attack. In this way, they start to fear that their panic attack will be the cause of their deaths. This causes more avoidant behavior, as people try to minimize the possibility of ever having a panic attack. (We will examine a hypothetical case history involving this fear in Chapter 4). Oftentimes, people start to panic about the possibility of panicking, and so cause the very thing they were afraid of. The important thing to remember is that, as we said above, panic attacks are not dangerous. While they are distressing and uncomfortable, and often frightening, they will not themselves cause physical harm to your body. Both your heart and your psychological fear response evolved over time to serve the same function: namely, to keep you alive. They will not quit on you, and they will not turn on one another. Likewise, if you experience an arrhythmia, it can't be a bad idea to consult a nurse or doctor about it, but you can also remind yourself that arrhythmias are normal and are often related to other physical causes that are not dangerous in themselves. Even though it's absolutely necessary and the most rewarding, few of us have our act together because, overall, it's not very fun. A lot of the time, it's boring, uncomfortable, mentally and physically tough, and it seems everyone is having an easier time. It seems you're having the least fun. It seems the excessive and extreme rules and boundaries are taking away your freedom. But this is just the childish part of your mind trying to convince you to give up and quit because it doesn't like constraints, rules, and boundaries. It doesn't want to grow up with you. It wants to be free so it can screw up your life again, lead you back down the wrong path, and undo the hard work you've put into getting your act together.