“Am I having a panic or anxiety attack as there have been a couple of times this week when I was in an uncomfortable situation and my heart began to race and I got all sweaty and had trouble breathing?” I explained to my patient that she was probably experiencing a panic or anxiety attack and these attacks are common in early recovery when the brain chemistry is still disturbed. The brain is no longer regularly tranquilized by alcohol, but neither is it making its own tranquilizers yet. So when increased sensory stimulation like an uncomfortable situation occurs, it triggers anxiety and there is nothing to calm it down. Once you experience such an episode, it can feed on itself. Even the fear of having another panic attack can trigger one. Anxiety prevents the alcoholic from solving problems effectively and efficiently and could lead them into emotional chaos and back to the bottle. The unwanted effects of anxiety lead to low levels of performance whenever the task to be done is in any way difficult. It follows that we could expect high anxiety to lower the standard in interviews, social situations examinations and in occupational areas whenever the stress factor is high and is evaluated as a threat. An alcoholic cannot afford to maintain high anxiety states and should seek help from their doctor or counsellor. By the same token, don’t be coerced into taking tranquilizers as they are addictive. Antidepressants are not addictive if your doctor sees your anxiety as part of depression. High levels of anxiety often lead to failure and the recovering alcoholic needs to be vigilant at all times. High levels of anxiety that lead to failure also lead to a drop in self-esteem, which leads to a drop in confidence. Success lowers anxiety levels and raises self-esteem Failure raises anxiety levels and lowers self-esteem. Stress is neutral. Only if we interpret it as a threat does it cause anxiety. Step 7 in the 12 Steps of Alcoholics Anonymous requires the alcoholic to look at the characteristics of anxiety provoking situations and the ineffective ways anxious people behave in these situations. We have as our main motive in life an overwhelming fear of losing something or someone we have, or of failing to get something or someone we want.  Usually this “something” is approval by others. We are people-pleasers who say and do things to please others instead of saying and doing things because they are the sensible thing to do.  What does a “people pleaser” carry around with them? Fear of not being accepted, fear of rejection, fear of fear itself and a good dose of anxiety. We see ourselves rather than what is happening as the focus of interest. That is, we have a “center of the universe” theory of life with self as the center. We worry about failing and being seen to fail by others. We worry about being rejected by a person or a group of people. We worry about the possibility of negative appraisal or evaluation by others because we won’t measure up in some way. We over-value the opinions of others and are dependent on them for approval. We live in the past and we live in the future. We become perfectionists to try to avoid criticism. We procrastinate and become indecisive. We avoid situations where we think we might become anxious. There are additional ways of heading off these early recovery anxiety attacks and of stopping them once they begin. Avoid caffeine in coffee, tea, soft drinks and over-the-counter medications. Make an effort to learn meditation, deep breathing exercises and other relaxation techniques which can help break the cycle. These are excellent tools in recovery because they can head off a pending anxiety attack or curb one that has stared. Try to identify the hot button that has been pushed – a person, place, thing or situation and then try to diffuse it by changing your thinking to change your feelings (emotions) to ultimately change your behavior. As well as 100% vigilance, you need to take care of your nutrition and dietary supplements. We recommend Tyrosine Mood Food, necessary for the manufacture of dopamine and noradrenaline, which are required for concentration, alertness, memory and a happy, stable mood. Tyrosine is required for the manufacture of adrenalin in the adrenal glands and most alcoholics suffer with adrenal exhaustion. The state of your liver has a big impact on your state of mind so that those with a fatty liver may find themselves irritable and moody with a poor memory and difficulty keeping up with life’s demands. Depression and poor sleep may be associated with a fatty liver and these things resolve when we improve the liver function.  We recommend Livatone Plus Powder or Capsules, a more powerful formula that can support liver function when there are more serious liver problems due to alcoholism. L Glutamine is an amino acid and has been shown to improve brain function in alcoholics, resulting in improved sleep, decreased anxiety and a reduced craving for alcohol, and it is the principle ingredient in Ultimate Gut Health.   The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.