Pamela Loosli

One out of ten people are likely to develop an anxiety disorder in their lifetime. The first panic attack feels like a heart attack. “Fear only gets rid of those who realize that they have some psyche issues”, says psychologist Pamela Loosli. But then panic attacks can be treated according to the conditions.

Fear is part of people; it has a warning function that helps us to protect ourselves from dangers. For example, when crossing the street. However, if we are afraid of situations that are not dangerous, such as riding a lift or going to the cinema, then it loses its warning function. And people with such fears are often considered failures.

Anxiety disorders

Patients with anxiety disorders get great anxiety and panic attacks with chest pain, tremors and shortness of breath out of the blue. The longer you wait with treatment, the stronger the fears become.

The mental illness is widespread: one in ten people develops an anxiety disorder in their life, shows in a study by the University of Minnesota.

Nevertheless, there are well-known personalities who stand by their panic attacks, such as the Sissach Singer, Ira May or, the Swiss journalist, Silvia Aeschbach. And in the American series “Suits”, the “most successful and most expensive corporate lawyer in New York” suffers from it.

It seems to be trending for celebrities to publicly stand up for their mental illness, including depression and burn-outs.

Don’t you think that’s a good thing?

I always find it good to be able to read reports from those affected. This helps to remove the taboo from mental illnesses. Because you often hear that people with mental illnesses are nuts who belong in a clinic.

Pamela Loosli also talked to those affected. They said they were scared before the vacation. Is traveling a terrifying thing?

There are situations that anxiety patients typically fear, for example, cramped rooms in which one is locked in and from which one cannot leave, such as in the plane, in the elevator or in the cinema. Or large crowds.

Why is that causing such great fear?

Most of the time, prolonged stress is the cause. Everyone experiences stress now and then and people have strategies to reduce it again. But there is a threshold, and if you cross it, you can lose control and have the first panic attack.

“You’re on your way home in the car and suddenly your chest hurts, you can’t breathe, sweat and shiver and feel passed out.”

What if you lose your partner or your job?

Often a little something can bring the barrel to overflowing – for example, a car-drive after work, when suddenly your chest hurts, you can no longer breath, sweat and shiver and a feeling of powerlessness spreads.

Is this a reason many think they are having a heart attack?

Exactly. And afterwards they fear that it will happen again and that they will die in the process. And then the avoidance behavior begins.

Pamela Loosli explains the diathesis stress model, a complicated term for a plausible explanation: If you have been stressed for a long time, the body runs out of reserves to reduce it until it bangs. (Photo: Nils Fisch)

The patient avoids situations in which he could get scared?

Yes, these situations are actually not decisive at all. But after an attack in the car, the person concerned associates the symptoms of anxiety with driving, and avoids getting back behind the wheel. If he then experiences a second attack while shopping, this situation will also be avoided in the future. This can go so far that the patient no longer dares to leave the house.

Does that mean that anxious patients do not even notice that stress is triggering their suffering?

Yes, most of them think there is something physically wrong. So you go to the doctor and he won’t find anything. Until a diagnosis of panic disorder is made, the patient may go through a proper doctor-to-doctor odyssey. 

“There are men who give everything for the job and don’t admit that they feel stressed. It’s a kind of repression. “

I don’t understand: How can you have such stress without feeling the stress?

I don’t want to start a gender discussion now, but there are men who are used to giving everything for the job and not admitting to themselves that they feel stressed. It’s a kind of repression. If you show them that their workload is high, there is a problem in the family, or matter of legal separation, and then tell them that their job is in danger – only then do they realize how stressed they actually are.

Are there people who have weaker nerves and who tolerate stress worse than others?

You can’t say it like that. There are simply people who can deal better or worse with stress or stressful situations. What matters is what kind of social environment you have, whether someone can get help from friends. But also whether someone has hobbies where you can relax.

What does it depend on – childhood and genes?

You don’t really know. What You Know: Adults who suffered from separation anxiety in childhood tend to be more likely to develop anxiety disorders.

These are children who can hardly break away from their parents.

Yes, for example children who panic when they come to kindergarten and cling to mommy. Often these children later become homesick children who almost can’t stand it in the school camp.

Where do these separation fears come from?

There are several causes. If a child experiences a longer absence from one parent due to illness, this can be very unsettling and encourage separation anxiety.

Can this also happen with divorce?

Yes, of course, such cuts in life mean massive stress for children and adults. Children who know stable relationships and where they belong are better able to cope with difficult situations, possibly later than adults too.

Extreme sport helps against stress. The vegetative nervous system is so strongly excited that the body automatically relaxes afterwards.

Parents with anxiety disorders often fear for their children. How’s that for the kids?

It is often the case that mothers or fathers with anxiety disorders raise their children very protective and anxious. The children orient themselves to the behavior of their parents and often adopt it. 

That sounds very psychoanalytic now. Can you also be at a higher stress level from birth, biologically, so to speak?

Yes, in some people the autonomic nervous system is activated faster than in others: the body releases stress hormones such as adrenaline, the heartbeat goes faster – and people feel stressed.

And then do you get an anxiety disorder?

No. There are people who have very good strategies for dealing with this, for example by doing extreme sports like skydiving to reduce stress.

Excuse me, extreme sports relaxed?

Yes. And also endurance sports. That gives a kick that excites the nervous system strongly. When the maximum is reached, the nervous system automatically breaks down the stress hormones and relaxes the body.

If you go to maximum stress, does relaxation automatically follow?

Exactly, at some point the body cannot help but go down because it has no more energy or because the kick dies down. Extreme athletes play with it. And it’s the first thing panic patients learn from us. You often have the feeling that the panic could only increase. That is why they are so afraid of the fear. But once you experience firsthand that the fear is going away again, that calms you down.

So do you send panic patients to skydive?

No, the most important thing is to tell them what exactly is going on physically when an attack comes. That takes away the drama of the bugbear. We confront the patients with special situations. If someone is afraid of using the lift, we go to take the lift – until we relax. 

Does that mean the patients learn to withstand the attacks?

Yes, but the goal is that, ideally, no more attacks occur at all.

Do you have success with it?

Yes, panic attacks can be treated very well. The earlier the patients come, the better. Perhaps they never become completely free of fear and have panic attacks from time to time in difficult life situations, but they develop a better way of dealing with fear. This often brings great relief. Most of my patients have jobs and manage their everyday lives despite the anxiety disorder.

“If the boss expects you to always check your e-mails in the evenings, on weekends and during the holidays, that triggers the stress.”

With the same stressful everyday life as before?

Patients have to turn their lives upside down. In group therapy, we first take a close look at the agenda: How do I set my appointments, do I have time for myself in which I can do sports, read a book or take a walk in nature? It is important to set aside half an hour a day to find a balance. 

Relaxation at the push of a button, that’s tricky.

We practice progressive muscle relaxation with the patient. Using this technique every day decreases the base level of tension. This creates a buffer against stress and is less prone to panic attacks.

Somehow, the stress in our society almost seems to be part of normal everyday life.

An important point is the electronic accessibility by mobile phone and computer. This constant networking naturally triggers our stress. Even more so when the boss expects us to check our emails on weekends and holidays and always reply immediately. But we won’t see how that affects mental health for a few years.

When printing and television were invented, it was said that the world was going to end – but it was still rotating.

I don’t think it’s going down, thank God we’re adaptable.

About the Author

The psychologist Pamela Loosli (37) has been leading group therapies for overcoming anxiety at the University Hospital Basel for ten years and has been providing individual therapy for anxious patients.