Who has experienced a Panic Attack? … No? Yes? How about a near or almost attack?

It can feel as though you are having a heart attack and your body can seem to be staging an all out protest. You may even feel as if your body is attacking you. Most people report feeling absolutely and completely unable to control their body. This in itself, is very frightening – which unfortunately makes the Panic Attack worse by prolonging it.

So … the most frequently asked question, in my experience, about Panic Attacks – is “How can I stop them?” Good question. First things first, it is necessary to understand what is happening in the body that is causing the Panic Attack to take hold.

Panic Attacks are caused by a combination of Biological, Emotional and Psychological Reactions. The Emotional Reaction is fairly easy to comprehend – FEAR! Is generally what people describe. However understanding the Biological and Psychological Reactions that cause a Panic Attack requires careful examination. Let’s look at them separately.

Biological Reaction 1: “Fight or Flight”

The Fight or Flight response is one of the adaptive mechanisms our bodies are capable of – that has successfully, albeit not necessarily comfortably, ensured the survival of the human race – at least up to this point. This response system is our basic ALARM and ADAPT mechanism and it will be triggered when our perceptual system, that is the combined processing of our senses and our Brain, detects danger. The danger detected may be real or it may be perceived – to the Brain there is no difference. If Brain detects danger in this way, it will immediately hit the PANIC BUTTON which in turn activates a variety of biochemistry including the release of adrenaline that enables your body to either “Fight” or “Flight”, so you live and protect the integrity of your body.

Here is a short list of some of the physical changes that happen when your Brain activates the “Fight or Flight” response:

1. Heart Rate and Strength of Heart Beat Increases. This is important and just like revving a car engine, increases potential power by facilitating enables blood and oxygen to be pumped around the body faster.
2. Rate and Depth of Breathing Increases. This in turn enables greater amounts of oxygen to be used by the body.
3. Sweating Increases. This is an interesting one. It is hypothesized that this makes the body more slippery and therefore harder for a predator to grab. It also helps cool the body down and opens an addition excretory channel, possibly needed to removed a temporary increase in cellular waste from using additional oxygen, quickly.
4. Muscles Tense. This is assumed to occur preparing for “Flight, Flight”. Everyone has watched a domestic cat practice pouncing and this response is similar to preparing to pounce, but never actually pouncing. It is a kind of stuck pounce which will elicit feelings of tension that can morph in to aches, pains, even trembling or shaking. If this occurs – Body and Brain are confused. The ALARM has been activated but there is no danger to run from or to stand and fight.

Biological Reactions 2: Hyperventilation & Anxious Breathing

Breathing is a fundamental activity needed to sustain life. The gas exchange between oxygen, inhaled, and carbon dioxide, exhaled, is one of the most fundamental feedback mechanisms our Body and Brain monitors when maintaining homeostasis. Efficiency in the Body depends upon the balance between oxygen and carbon dioxide. This pivotal balance becomes disrupted when we over breathe or breathe rapidly, common pattern of breathing when we are anxious.

Over Breathing or Rapid Breathing results in an imbalance in the gas exchange which when the Body-Brain system detects this, will release a number of biochemical responses. Symptoms such as dizziness, light-headedness, confusion, breathlessness, blurred vision, increase in heart rate, numbness and tingling in the extremities, clammy hands and muscle stiffness will emerge as a result.

These physiological sensations can be quite distressing, if they are either not well understood or if you have already developed a tendency to experience Panic Attacks. These sensations can be interpreted as a sign of an oncoming Panic Attack, or something dangerous such as a heart attack. However this is not the case. It is an interpretation of the biochemical responses elicited by either Over Breathing or Rapid Breathing. This also means that taking control of your Breathing is an effective way to short circuit the cycle.

Psychological Reactions 1: Thinking Patterns or Habits commonly associated with Panic

People who panic or suffer from Panic Attacks have developed some habitual ways of thinking and acting that perpetuate the ‘panic’ response. They are excellent noticers of these symptoms. In fact, they are so good – their skills border on and can grow in to obsessions. People who panic can be constantly engaged in scanning their bodies for symptoms of panic. This habit of monitoring internal sensations can, after a while, become automatic.

Once the person detects a symptom or a sensation they perceive as a symptom of panic, they will interpret this as a sign of danger which in turn creates the perception that there is something wrong with them, that they must be crazy, out of control or even believe that they are going to die.

There are a number of Perceptual Errors (Thinking Patterns or Cognition Habits) that often occur during panic, including:

1. Catastrophic thoughts about normal or anxious physical sensations (eg “My heart skipped a beat – I must be having a heart attack!”)
2. Over-estimating the chance that they will have a panic attack (eg “I’ll definitely have a panic attack if I catch the bus to work”)
3. Over-estimating the cost of having a panic attack: thinking that the consequences of having a panic attack will be very serious or very negative.

Psychological Reactions 2: Behaviours that Keep Panic Going

Feelings of Anxiety or being in situations where previously we have felt anxious in some what will prompt us to adapt, that is, to act in a way that establishes a sense of control over our situation, ourselves and our environment. We are all, in a way – Control Freaks. It is why we are still alive – but, when it comes to experiencing excessive anxiety – we may discover some short term benefits by noticing what happens when we keep away from situations that provoke panic or anxiety. We might learn or decide that avoidance is the way to establish control. But if we do this – we pay a high price in the evolutionary stakes.

Avoidance can include:

1. Situations where you’ve had panic attacks in the past
2. Situations from which it is difficult to escape, or where it might be difficult to get help, such as public transport, shopping centres, driving in peak hour traffic
3. Situations or activities which might result in similar sensations, such as physical activity, drinking coffee, having sex, emotional activities such getting angry

A second response may be to behave differently. People can develop what is known as “Safety Behaviours”. They establish a false sense of security.

The following are examples of these;

1. Make sure you are always near an escape route
2. Carry medication with you
3. Position yourself near a wall to lean on
4. Use distraction techniques by seeking reassurance, reading something, or having music with you, so you can listen to it

Using Safety Behaviours too much, is a bit like taking Psychological Valium. Works pretty good for the first week – but then you are addicted and your Safety Strategies will control you, rather than you being in control of ‘them’. You will experience even more intense distress if for some reason you cannot use them.

It is important to relate to the internal sensations of Panic differently. Meet the experience, embrace Mindfulness, get to the bottom of the signals.

What is your Panic trying to tell you? Believe it or not, your Body is talking to you. Your Body is trying to keep you alive, and more than that – to be happy.

Although this may not seem harmful to begin with, if you become dependent on these behaviours you can become even more distressed if one day it’s not possible to use them.