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    Carrie Underwood's Secrets for Healthy Living -- On and Off the Road

    The country music star talks about her diet, her exercise, her dog, and how she handles her fear of crowds.

    Carrie Underwood and Panic Attacks continued...

    Underwood has said that when she was in high school, she suffered from panic attacks. Christmas shopping, in particular, "seemed to be my worst nightmare," she says. "I'm a big personal space person. You know, if you go to the restroom, you use the stall that's not near anybody. Or if you're in the gym, you go to the treadmill where there's space in between you. And it seemed like in crowded situations like that, people would just completely violate your personal space. So whenever I'd be in stores and there would be people touching me and kids running around, I couldn't take it and I'd have to leave."

    David D. Burns, MD, clinical psychiatrist and author of When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life, says that being in crowds is a common trigger for a panic attack. More than 6 million Americans are affected by panic disorders, which often begin in late adolescence, according to the National Institute of Mental Health.

    These attacks, says Burns, are characterized by "feelings of extreme terror that seem to come out of the blue. The feelings quickly reach a crescendo and then typically disappear within 10 or 20 minutes, leaving you feeling terrified and ashamed, and wondering when the next attack will strike again."

    Panic Attacks: A Treatable Disorder

    Along with anxiety, physical sensations of a full-blown panic attack can include dizziness, a racing heart, tightness in the chest, a churning stomach, and tingling skin. "At the same time, you have the intense belief that something terrible is about to happen," he says. "You think you're on the verge of dying, passing out, going crazy, or losing control. These distorted negative thoughts actually trigger the feelings of panic."

    Many panic attack sufferers, he says, mistakenly think they have a medical problem, such as a heart attack or stroke, "and they spend years going to emergency rooms and cardiologists before a proper diagnosis is made."

    Fortunately, panic disorder is one of the most treatable anxiety disorders; drugs, cognitive behavior therapy, and exposure therapy can all help, Burns says. "In most cases, people can be 'cured' more or less completely in just a few sessions, without any medications, using some of the newer techniques."

    Underwood says her panic attacks are now well under control, but when she shot to fame on American Idol, she had to adjust to groups of excited fans. "They feel like they know you and they love you and that's wonderful -- they're excited to meet you," she says. "It just took me a minute to be able to figure that out and to be able to allow people into my space."

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