For almost 30 years I’ve lived with a debilitating and chronic panic disorder with side orders of social and generalized anxiety. Being diagnosed with panic attacks and severe anxiety at 9 years old was not only terrifying, but extremely confusing. I didn’t know what was going on inside my body, and seeing my mother’s reaction as I would have multiple panic attacks only made the anxiety worse. Over the past three decades, I have developed a much deeper understanding of not only what my own triggers and antecedents are, but how to manage my anxiety.
When I began solo hiking in 2015, I had to learn how to overcome a new set of antecedents in the backcountry. Spending time outdoors can be extremely beneficial for alleviating stressors, anxiety, and depression, but there have been many times when being in the wilderness has triggered my panic disorder. Although every person has a unique set of strategies that works for them, there are tools that many people can benefit from to help manage anxiety and stressors while hiking.
What Causes Anxiety?
Generalized anxiety, panic disorder, and social anxiety are all clinically defined and require a diagnosis from a licensed professional. But just because you don’t have a diagnosis doesn’t mean you aren’t experiencing anxiety or having panic attacks. Before you can manage or learn to identify your anxiety and what triggers it, you first have to understand what anxiety and panic attacks are, how they are different, and what causes them. Anxiety can be caused by any number of things. Most people will experience anxiety many times over the course of their lives. A panic disorder is much more severe and debilitating than general or social anxiety. A person may be diagnosed with generalized anxiety and never experience a panic attack; however, if someone is diagnosed with a panic disorder, they will likely also carry a diagnosis of generalized, social anxiety, or both.
Recognizing the symptoms of a panic attack may alleviate some of the stress associated with it. Having spent over a decade experiencing panic attacks daily, I learned how to identify my own symptoms. But I never knew what caused panic attacks until I got older and researched what a panic attack actually is. I had spent over a decade having these terrible and debilitating bouts of panic with a whole slew of physical and psychological symptoms, but I didn’t know why they were happening. Eventually I found out that panic attacks are quite simply the body’s fight or flight response being triggered.
This was cathartic to finally know. The physiological and psychological symptoms all made sense once I understood the reason. I was having this intense feeling of being in a life-threatening situation because something had triggered the fight-or-flight center of my brain.
Understanding what and why we have panic attacks has helped me manage the onslaught of symptoms associated with the actual attack; however, as most people who live with panic attacks know, there is really no way of talking yourself out of having one.
Explaining the difference between a panic attack and anxiety is also extremely difficult. I have attempted to walk someone through my own experiences, however, the only real way to understand the difference between anxiety and a panic attack is to have a panic attack. Despite understanding the cause of my disorder and being medicated to alleviate some of the more severe symptoms, I still experience panic attacks and have had to learn how to manage them not only in my day-to-day life, but when hiking.
How I Manage Anxiety and Panic Attacks While Hiking
Before we get into it, know this: I am not a licensed psychologist and these are things that work for me; they may not work for everyone. I cannot stress enough the importance of seeking professional help if you are experiencing symptoms of anxiety, panic attacks, or concerned about your own mental well-being.
First and foremost, determining which coping mechanisms alleviate your anxiety is as important as your own personal gear list. For example, being around people when I’m experiencing a panic attack only heightens my symptoms. Conversely, my mother becomes more anxious when she is experiencing a panic attack alone, and seeks out other people to alleviate her symptoms. This is why it is important to work with a professional, read about anxiety and panic attacks, and educate yourself about what does and doesn’t work before going into the backcountry. Think of it as the opposite of a shakedown hike, when instead of going into the woods to test your strategies, you test them before you go hiking in a controlled environment.
Knowing your triggers in day-to-day life can also apply to your triggers while hiking. Often the cause of my anxiety (which can turn into a panic attack) is getting too much into my own head. I will overthink things, hyper-focus on physical sensations I may be experiencing, and begin to work myself into a panic attack by thinking that I am sick or in danger. My phobia of throwing up is a huge trigger while hiking. That fear develops into a fear of the panic attack itself, which can lead to avoiding places from previous panic attacks, and develop into agoraphobia. I have begun to feel sick while hiking and been triggered into having a panic attack in the middle of the woods.
I can remember vividly, back in 2015, sitting on the side of the Mount Osceola Trail, talking myself down from a panic attack because I was convinced that I had overexerted myself and was getting heat stroke. On another hike, after over 1,500 solo miles, I had a severe panic attack on the Osseo Trail in the middle of winter. Regardless of how many thousands of miles you have in the backcountry, if you have a panic disorder or anxiety there will always be a possibility of having a panic attack while hiking. Learning to manage and identify the symptoms and to talk yourself down during an attack is key to decreasing the number of instances you experience panic attacks or anxiety while hiking.
Becoming comfortable in the woods, whether in a group or solo, will decrease the amount of triggers. When I first started hiking, I was terrified of what was “out there” in the woods. I would get nervous hiking in low visibility, fog, or cloudy weather, and would avoid looking anywhere but right in front of me on the trail. If I couldn’t see it, then it couldn’t “get me.” The more miles of hiking I did in these conditions, the more comfortable I became. Now I love to look around when I’m hiking. Experience can be a wonderful way to eliminate a trigger, but going through the process of gaining that experience isn’t always easy.
Sometimes you have to push through the voice in your head telling you to turn around, or that you’re in danger. Sometimes you don’t have a choice but to push through the sense of impending doom because you’re in the middle of the woods and can’t call it quits. These are the hardest situations that I’ve encountered, and are the times when I reach into my own toolbox and use strategies that help me calm down and get back to my car safely. They are also the experiences that I use to remind myself that I can do hard things and still be OK when I encounter another panic-inducing situation. Over the years, I have collected a substantial number of these experiences when I had no choice but to keep going forward, despite the fear. Reaching for those memories, reminding myself when I’m terrified on trail that I have done this before and was fine, is one of the tools that I use to push through a panic attack.
My favorite way to manage anxiety on trail and off trail is what I like to think of as mirroring. As a teenager, nighttime—specifically bedtime—was a trigger for me. My anxiety would heighten and I would end up on the couch trying to talk myself down. One thing that helped me become less anxious was watching TV. It was a distraction from the racing thoughts, and it also helped to watch people being calm and “normal.” I would use those actions as examples of how I should be acting and feeling. I would tell myself, “They are OK and doing normal things, you’re OK too.” This is still one of my most effective strategies in bringing down my anxiety.
On trail, I use a very similar technique. But instead of watching TV, I listen to podcasts, specifically ones about hiking. I intentionally listen to fellow hikers talk about terrifying and dangerous experiences in the backcountry, and then tell myself, “They made it out OK, and what you’re doing isn’t that dangerous, so you will be OK too.” This method works at bringing down my anxiety and distracting me enough to calm down in over 95% of the situations I use it in. In the other 5% of situations, I usually end up crying, having a mini meltdown, and then finally pull it together and get myself out of the situation. This leads me to my final point about managing anxiety in the backcountry.
It’s OK to Have Anxiety
One of the hardest things about anxiety and panic attacks is the feeling that you can’t allow yourself to have one. You may feel stress because you either feel weak or ashamed that you have this disorder and want to hide it, or you are always worried that giving in to the panic or anxiety will lead to more intense panic and anxiety. There have been three instances when I didn’t or couldn’t fight down the panic and had a full-blown attack in the woods. This is what anyone with these diagnoses wants to avoid, which is why we use techniques to talk ourselves down from most of the bad attacks.
Not everyone will agree with this, but I believe it’s OK to have a panic attack, to not use all your energy to fight it, or be unable to fight it off. More importantly, I’m here to tell you that it will be OK and you will live, despite feeling like you will die.
Those three experiences when I couldn’t fight it off were the most terrifying things that have happened to me in the wilderness, but they were the experiences that taught me the most about my own ability to persevere. Sometimes going through the fire allows you to develop new tools, and shows you that the thing that scares you the most can be nothing at all.
Everyone’s Toolbox is Different
The best advice I could give someone who has a diagnosed anxiety or panic disorder, or experiences anxiety in the backcountry, is it’s OK to have anxiety and panic attacks in the backcountry. It’s not OK to let the fear stop you from hiking. Try to fight through the desire to “flee.” If you allow your anxiety and panic to dictate where you go and what you do, your world will inevitably become smaller and smaller until you can’t go anywhere or do anything. This is what happened to me in 2006 when I decided I didn’t need to be medicated anymore. I began to experience panic attacks, gave into the fear, and was unable to leave my house.
The next best advice I could give to someone with anxiety or panic is not to be embarrassed, ashamed, or too proud to seek professional help or get on medication. Unfortunately, mental health disorders are still stigmatized in our society, but you wouldn’t fault a person with type 1 diabetes for needing insulin, so why would you fault someone with a panic disorder for needing anti-anxiety medication? We have a chemical imbalance, we didn’t choose to have it, and there is nothing to be ashamed of.
Learn what your triggers are and what tools help you manage them. I have lived with a panic disorder for almost 30 years, and every day I am amazed at what I can do. That ability didn’t come easy and I am still learning how to experience panic attacks, sit with them, allow them to progress, and not flee.
Distractions like music or TV, breathing techniques, and self-talk are all things that I use on a regular basis to manage my anxiety both in my day-to-day life and on hikes. Taking the time to learn about anxiety and panic attacks, getting help from professionals, and then actively using the tools and techniques to see what works for you is the only way to manage anxiety in life and in the backcountry. Talking openly about mental health disorders is the only way to remove the stigma associated with them and support the individuals, like me, who will spend their lives managing one.