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Backpacker Magazine –

The First 30 Seconds

What you can do to thwart a panic attack in two common crisis situations

by: Jason Stevenson

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Wilson's cue word is much like a Buddhist mantra. Using the same phrase repeatedly can actually signal your brain to produce calming chemicals such as serotonin, the neurotransmitter responsible for feelings of happiness. Serotonin offsets another neurotransmitter, none other than norepinephrine.

"In a panic situation, our reptilian brain shouts, 'I'm prey! I'm going to die! Run. Run!'" says professor Kathleen Hall, author of Life in Balance: Nourishing the Four Roots of True Happiness and the founder of The Stress Institute in Atlanta. "By using a simple affirmation—'I am in control' or 'I can handle this'—you're telling the brain, 'Nope, that's not the situation.'"

Hall describes this as the quintessential difference between control and powerlessness. Most people who die in the wilderness have lost heart and believe they cannot control the outcome of their predicament. Kodikian and Coughlin are good examples: They so thoroughly convinced themselves that they were helpless they saw suicide and then murder as the only alternatives. The calming-breath-with-mantra is a method for disarming the alarm system, regaining control, and accurately assessing your reality.

"Once you regain your composure," says Wilson, "you're already halfway out of the woods. The next step is to take a mental inventory. Itemize all those things you have going for you—your strength, your outdoor skills, your attitude. Recognize that you are well-equipped for this challenge."

After an optimistic listing of your intellectual capabilities, observe and inventory your situation. How far are you, honestly, from road? How badly hurt, truly, are you? Will it storm in the afternoon? Will it be a chilly night? With a calm mind, you should be able to distinguish between perceived dangers—darkness, for instance—and real dangers, like a cold, windy rain.

Finally, put it all together—your attitude, your skills, your environment—devise a plan of attack, and then execute it methodically, with a willingness to change course when new information presents itself.

Much of the conventional wisdom regarding panic has come from psychiatrists, psychologists, and therapists studying mental illnesses: anxiety disorders, post-traumatic stress disorder, obsessive/compulsive disorder. Notably, the basic physio-psycho mechanisms of panic are the same whether you're panicking in the wilderness from a real threat, or experiencing a reoccurring panic attack caused by a mental condition. But experts say that there are important differences.

"In the backcountry," says Dr. Paul Auerbach, author of Wilderness Medicine and the blog Medicine in the Outdoors, "there are just too many variables. A person may be high-strung and have a low tolerance for uncertainty and for pain—all anecdotal indicators of a person who could panic," he says. "But let's say they're a good swimmer and feel comfortable in the water. Such a person may panic when trapped on a ledge high in the mountains, but might have no problems crossing a raging stream."

Likewise, a person who is afraid of the dark but feels completely comfortable with animals may freak when the sun goes down—and do just fine with a bear encounter. A climber with no vertigo may panic in a situation where she or her partner is seriously injured. Nonetheless, Auerbach believes that anyone who's in a weakened condition— extremely thirsty or hungry or cold, for example—could be more susceptible to panic.

"In extreme hypothermia as well as in extreme hypoxia—both of which can occur simultaneously on a mountaineering expedition—humans tend to become complacent and foggy, rather than panicked," says Auerbach. "Bad judgment is usually what first gets people into trouble. Bad judgment stems from lack of experience, lack of preparation, and faulty thinking. It leads to bad decision-making, which worsens the situation and precipitates panic." But what if you suspect you're prone to panic? The medical community has drugs for altitude sickness, infections, and pain. Recent studies even suggest that Viagra can stave off some of the effects of altitude. But does it make sense to pack prescription Xanax, a popular anti-anxiety medication, in the first-aid kit?

"Anti-anxiety drugs have been proven to effectively treat anxiety disorders," says Auerbach, "but they're probably not the answer for panic situations in the wilderness. They have numerous drawbacks: They affect each person differently and unpredictably, they require 15 to 30 minutes to take effect, and they often act as a sedative instead of a stimulant."



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