How do I start opening up to other people? And how do I start fixing myself?

Hi Sage!

Thank you for this great question.

My first suggestion would be to go to your primary care physician to rule any medical reasons for your mood swings and panic attacks. Sometimes it has very little to do with mental issues but rather something else going on in the body. I would rule out anything physical first.

If that comes back negative, meaning there aren’t any physical/medical issues that are causing these mood swings and panic attacks, we have to now look at psychological reasons.

The first sense I got from your question is that you don’t feel grounded.    Something is scaring you and when you get “triggered,” it’s hard to control your mood and emotions. So, first we have to work on some grounding techniques when you feel your mood changing.  In its simplest form what you want to do is change or activate a different part of your brain. For example, if the part of your brain activated has to do with mood swings and panic attacks, you need to deactivate that part and activate the part of brain that is associated with calm and an even mood with little to no anxiety. In the moment, one of the most effective ways to do this is by doing some “box breathing.”
The box breathing technique is just as it sounds.  

• On the top row across, you want to inhale a deep breath in for 4 seconds.
• On the way down you want to hold in your breath for 4 seconds.
• On the way across you want to exhale your breath (breath out) for 4 seconds.
• On the way back up you want to hold your breath for 4 seconds.
• Repeat as often as you need/would like to perform this routine.

By engaging with this breathing exercise, you are essentially deactivating the areas in your brain that in that moment are out of control in some way.

The following are some strategies to explore when you are not in the midst of a mood swing or panic attack;

1.     Exercise: A regular exercise routine is extremely important. By engaging in some type of exercise you are allowing the feel-good chemicals in your brain to activate, thus achieving the “runner’s high.” If done in the morning, this can have a positive and calming impact throughout your day.

2.     Food/Nutrition: Food is also going to play a significant role in reducing and hopefully eliminating these massive mood swings and panic attacks. I am not a nutritionist but I do know certain foods can play havoc with our bodies' ability to function at its best. Certain foods can also help regulate moods and reduce anxiety.

3.     Sleep! Sleep is perhaps one of, if not the most, important actions we can take for our overall health and well-being.    However, there are some things that can prevent us from getting the quality and quantity of sleep that we need to function at our best.

• Caffeine a few hours before we go to bed will result in difficulty going to sleep and staying asleep.
• Electronic usage before we go to bed can also negatively impact our sleep. The effects on the brain when we go online (social media) is to activate/stimulate the brain thus keeping us awake.
• Food can also impact our ability to get good/quality sleep. Certain foods we eat can cause heartburn waking you up at night. Eating before you go to bed can make it difficult to fall and stay asleep
• Exercise can have a positive impact on your sleep quality and quantity. Try and get at least some walking into your daily routine.

4.     Journaling: When you are grounded, perhaps before you go to bed or when you wake up in the morning, it might be a good time to do some journaling. Simply right down any thoughts, feelings, behaviors that you have and/or have had throughout the day. See if you can connect them with anything else. For example, did anything happen right before your mood went up or down? What was going on at the time of your panic attack? The idea is if you can begin to track when these happen, perhaps you can begin identifying the “triggers.”  Once you can identify those triggers, then perhaps you can anticipate them better or even avoid them moving forward.

I wish you the best of luck on your journey to health and happiness.

Steven R. Levey, PhD, LCSW