Panic Attacks: How They Take Over

Since many survivors of a traumatic life event(s) experience the grip of panic attacks, I want to focus on demystifying these, sometimes painful and often frightening, experiences. While it may seem that there is no benefit from a panic attack, in its essence, a panic attack is an attempt by your body and mind to protect you from a perceived danger.

In a previous article, Understanding the Physical Impact of Extreme Stress, I discussed the impact of stress on the body and mind. The brain receives information about the status of the world through your five senses. Once this information reaches the brain, the first stop is a danger detection center that determines whether the incoming information indicates a danger or threat. If there is a threat, the body can go into fight, flee, or freeze. Some physical changes the body makes include: an increase in the rate of breathing, a faster heart rate, higher blood pressure, the funneling of blood to your running/fighting muscles, increased muscle tension, pupil dilation, an increase in sweat, increased pain tolerance and, finally, a bolstering of your immune system.

Panic attacks occur when the mind & body misperceive a minor or imagined source of danger; rather than responding with either a low stress response, the danger detection center ignites a full-blown stress response. For example, someone with a fear of dogs sees a Dachshund puppy on a leash across the park—information from the senses—or someone in excellent health who fears a heart attack notices a heart palpitation and interprets it as a sign of heart failure—information from inside the body—and the mind and body start entering a protective (panic) mode.

In addition to the triggers being misread, the bodily changes, which ensue due to the stress response, are interpreted as new sources of information. This information says that you are facing a major threat, hence increasing the already heightened danger detection center’s response. This misreading of both external triggers and internal body states results in the mind and body ramping-up to tackle what is being falsely regarded as a significant threat to safety.

The intensity of the panic attack, in turn, reinforces the misreading of the incoming information—since only danger would justify such a severe reaction, and since there was a severe reaction, there must have been danger. Over time, anything associated with the panic attack can trigger an attack; even just thinking about these associations or the actual trigger can ignite the danger response. I.e., just thinking about a dog, hearing a dog bark, seeing a park, feeling your heart rate, or noticing any “non-normal” physical sensation can induce a panic attack. This leads to more and more physiological experiences of danger, which reinforce the belief that you are genuinely in danger. Not only does this begin a vicious cycle, but it also leads to the avoidance of a panic attack becoming a prime motivator. Since avoiding a panic attack means avoiding triggers—those within your body, mind, and in the physical world—you begin to narrow your life experiences, which paradoxically strengthens the panic attack, ultimately leading to you losing out on the rich tapestry of life.

Thankfully, it is possible to block the progression of panic attacks and to, essentially, reverse the process that leads up to the attacks. A hallmark feature of all therapies, which aid people in decreasing their panic attacks, is slow and gradual exposure to the triggers, as well as replacing the danger response with a safety/calm response.

© Copyright 2011 by Susanne M. Dillmann, PsyD. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

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