Causes of Panic Attacks
Barry McDonagh analyses the causes of panic attacks, beginning with a definition of anxiety and describing the fight/flight response. It explains the physical and mental effects and gives some practical advice for coping with or avoiding anxiety.
The short and obvious answer: panic attacks are caused by high anxiety. But, what exactly is anxiety? Understanding how anxiety crops up will help you defeat panic attacks.
One of the biggest myths surrounding anxiety is that it is harmful and can lead to a number of various life-threatening conditions.
Definition of Anxiety
Anxiety is defined as a state of apprehension or fear resulting from the anticipation of a real or imagined threat, event, or situation. It is one of the most common human emotions experienced by people at some point in their lives.
However, most people who have never experienced a panic attack, or extreme anxiety, fail to realize the terrifying nature of the experience. Extreme dizziness, blurred vision, tingling and feelings of breathlessness—and that’s just the tip of the iceberg!
When these sensations occur and people do not understand why, they feel they have contracted an illness, or a serious mental condition. The threat of losing complete control seems very real and naturally very terrifying.
Fight/Flight Response: One of the root causes of panic attacks?
I am sure most of you have heard of the fight/flight response as an explanation for one of the root causes of panic attacks. Have you made the connection between this response and the unusual sensations you experience during and after a panic attack episode?
Anxiety is a response to a danger or threat. It is so named because all of its effects are aimed toward either fighting or fleeing from the danger. Thus, the sole purpose of anxiety is to protect the individual from harm. This may seem ironic given that you no doubt feel your anxiety is actually causing you great harm…perhaps the most significant of all the causes of panic attacks.
However, the anxiety that the fight/flight response created was vital in the daily survival of our ancient ancestors—when faced with some danger, an automatic response would take over that propelled them to take immediate action such as attack or run. Even in today’s hectic world, this is still a necessary mechanism. It comes in useful when you must respond to a real threat within a split second.
Anxiety is a built-in mechanism to protect us from danger. Interestingly, it is a mechanism that protects but does not harm—an important point that will be elaborated upon later.
The Physical Manifestations of a Panic Attack: Other pieces of the puzzle to understand the causes of panic attacks. Nervousness and Chemical Effects…
When confronted with danger, the brain sends signals to a section of the nervous system. It is this system that is responsible for gearing the body up for action and also calms the body down and restores equilibrium. To carry out these two vital functions, the autonomic nervous system has two subsections, the sympathetic nervous system and the parasympathetic nervous system.
Although I don’t want to become too “scientific,” having a basic understanding of the sympathetic and parasympathetic nervous system will help you understand the causes of panic attacks.
The sympathetic nervous system is the one we tend to know all too much about because it primes our body for action, readies us for the “fight or flight” response, while the parasympathetic nervous system is the one we love dearly as it serves as our restoring system, which returns the body to its normal state.
When either of these systems is activated, they stimulate the whole body, which has an “all or nothing” effect. This explains why when a panic attack occurs, the individual often feels a number of different sensations throughout the body.
The sympathetic system is responsible for releasing the adrenaline from the adrenal glands on the kidneys. These are small glands located just above the kidneys. Less known, however, is that the adrenal glands also release adrenaline, which functions as the body’s chemical messengers to keep the activity going. When a panic attack begins, it does not switch off as easily as it is turned on. There is always a period of what would seem increased or continued anxiety, as these messengers travel throughout the body. Think of them as one of the physiological causes of panic attacks, if you will.
After a period of time, the parasympathetic nervous system gets called into action. Its role is to return the body to normal functioning once the perceived danger is gone. The parasympathetic system is the system we all know and love, because it returns us to a calm relaxed state.
When we engage in a coping strategy that we have learned, for example, a relaxation technique, we are in fact willing the parasympathetic nervous system into action. A good thing to remember is that this system will be brought into action at some stage whether we will it or not. The body cannot continue in an ever-increasing spiral of anxiety. It reaches a point where it simply must kick in, relaxing the body. This is one of the many built-in protection systems our bodies have for survival.
You can do your best with worrying thoughts, keeping the sympathetic nervous system going, but eventually it stops. In time, it becomes a little smarter than us, and realizes that there really is no danger. Our bodies are incredibly intelligent—modern science is always discovering amazing patterns of intelligence that run throughout the cells of our body. Our body seems to have infinite ways of dealing with the most complicated array of functions we take for granted. Rest assured that your body’s primary goal is to keep you alive and well.
Not so convinced?
Try holding your breath for as long as you can. No matter how strong your mental will is, it can never override the will of the body. This is good news—no matter how hard you try to convince yourself that you are gong to die from a panic attack, you won’t. Your body will override that fear and search for a state of balance. There has never been a reported incident of someone dying from a panic attack.
Remember this next time you have a panic attack; he causes of panic attacks cannot do you any physical harm. Your mind may make the sensations continue longer than the body intended, but eventually everything will return to a state of balance. In fact, balance (homeostasis) is what our body continually strives for.
The interference for your body is nothing more than the sensations of doing rigorous exercise. Our body is not alarmed by these symptoms. Why should it be? It knows its own capability. It’s our thinking minds that panic, which overreact and scream in sheer terror! We tend to fear the worst and exaggerate our own sensations. A quickened heart beat becomes a heart attack. An overactive mind seems like a close shave with schizophrenia. Is it our fault? Not really—we are simply diagnosing from poor information.
Cardiovascular Effects Activity in the sympathetic nervous system increases our heartbeat rate, speeds up the blood flow throughout the body, ensures all areas are well supplied with oxygen and that waste products are removed. This happens in order to prime the body for action.
A fascinating feature of the “fight or flight” mechanism is that blood (which is channelled from areas where it is currently not needed by a tightening of the blood vessels) is brought to areas where it is urgently needed.
For example, should there be a physical attack, blood drains from the skin, fingers, and toes so that less blood is lost, and is moved to “active areas” such as the thighs and biceps to help the body prepare for action.
This is why many feel numbness and tingling during a panic attack-often misinterpreted as some serious health risk-such as the precursor to a heart attack. Interestingly, most people who suffer from anxiety often feel they have heart problems. If you are really worried that such is the case with your situation, visit your doctor and have it checked out. At least then you can put your mind at rest.
One of the scariest effects of a panic attack is the fear of suffocating or smothering. It is very common during a panic attack to feel tightness in the chest and throat. I’m sure everyone can relate to some fear of losing control of your breathing. From personal experience, anxiety grows from the fear that your breathing itself would cease and you would be unable to recover. Can a panic attack stop our breathing? No.
A panic attack is associated with an increase in the speed and depth of breathing. This has obvious importance for the defense of the body since the tissues need to get more oxygen to prepare for action. The feelings produced by this increase in breathing, however, can include breathlessness, hyperventilation, sensations of choking or smothering, and even pains or tightness in the chest. The real problem is that these sensations are alien to us, and they feel unnatural.
Having experienced extreme panic attacks myself, I remember that on many occasions, I would have this feeling that I couldn’t trust my body to do the breathing for me, so I would have to manually take over and tell myself when to breathe in and when to breathe out. Of course, this didn’t suit my body’s requirement of oxygen and so the sensations would intensify—along with the anxiety. It was only when I employed the technique I will describe for you later, did I let the body continue doing what it does best—running the whole show.
Importantly, a side-effect of increased breathing, (especially if no actual activity occurs) is that the blood supply to the head is actually decreased. While such a decrease is only a small amount and is not at all dangerous, it produces a variety of unpleasant but harmless symptoms that include dizziness, blurred vision, confusion, sense of unreality, and hot flushes.
Other Physical Effects of Panic Attacks:
Now that we’ve discussed some of the primary physiological causes of panic attacks, there are a number of other effects that are produced by the activation of the sympathetic nervous system, none of which are in any way harmful.
For example, the pupils widen to let in more light, which may result in blurred vision, or “seeing” stars, etc. There is a decrease in salivation, resulting in dry mouth. There is decreased activity in the digestive system, which often produces nausea, a heavy feeling in the stomach, and even constipation. Finally, many of the muscle groups tense up in preparation for “fight or flight” and this results in subjective feelings of tension, sometimes extending to actual aches and pains, as well as trembling and shaking.
Overall, the fight/flight response results in a general activation of the whole bodily metabolism. Thus, one often feels hot and flushed and, because this process takes a lot of energy, the person generally feels tired and drained.
Are the causes of panic attacks all in my head? is a question many people wonder to themselves.
The goal of the fight/flight response is making the individual aware of the potential danger that may be present. Therefore, when activated, the mental priority is placed upon searching the surroundings for potential threats. In this state one is highly-strung, so to speak. It is very difficult to concentrate on any one activity, as the mind has been trained to seek all potential threats and not to give up until the threat has been identified. As soon as the panic hits, many people look for the quick and easiest exit from their current surroundings, such as by simply leaving the bank queue and walking outside. Sometimes the anxiety can heighten, if we perceive that leaving will cause some sort of social embarrassment.
If you have a panic attack while at the workplace but feel you must press on with whatever task it is you are doing, it is quite understandable that you would find it very hard to concentrate. It is quite common to become agitated and generally restless in such a situation. Many individuals I have worked with who have suffered from panic attacks over the years indicated that artificial light—such as that which comes from computer monitors and televisions screens—can can be one of the causes of panic attacks by triggering them or worsen a panic attack, particularly if the person is feeling tired or run down.
This is worth bearing in mind if you work for long periods of time on a computer. Regular break reminders should be set up on your computer to remind you to get up from the desk and get some fresh air when possible.
In other situations, when during a panic attack an outside threat cannot normally be found, the mind turns inwards and begins to contemplate the possible illness the body or mind could be suffering from. This ranges from thinking it might have been something you ate at lunch, to the possibility of an oncoming cardiac arrest.
The burning question is: Why is the fight/flight response activated during a panic attack even when there is apparently nothing to be frightened of?
Upon closer examination of the causes of panic attacks, it would appear that what we are afraid of are the sensations themselves—we are afraid of the body losing control. These unexpected physical symptoms create the fear or panic that something is terribly wrong. Why do you experience the physical symptoms of the fight/flight response if you are not frightened to begin with? There are many ways these symptoms can manifest themselves, not just through fear.
For example, it may be that you have become generally stressed for some reason in your life, and this stress results in an increase in the production of adrenaline and other chemicals, which from time to time, would produce symptoms….and which you perceive as the causes of panic attacks.
This increased adrenaline can be maintained chemically in the body, even after the stress has long gone. Another possibility is diet, which directly affects our level of stress. Excess caffeine, alcohol, or sugar is known for causing stress in the body, and is believed to be one of the contributing factors of the causes of panic attacks (Chapter 5 gives a full discussion on diet and its importance).
Unresolved emotions are often pointed to as possible trigger of panic attacks, but it is important to point out that eliminating panic attacks from your life does not necessarily mean analyzing your psyche and digging into your subconscious. The “One Move” technique will teach you to deal with the present moment and defuse the attack along with removing the underlying anxiety that sparks the initial anxiety.
Barry McDonagh is an international panic disorder coach. His informative site on all issues related to panic and anxiety attacks can be found here: http://www.panic-away-program.com