Understanding Panic Disorder: Why Panic Attacks Happen and How Therapy Can Help
If you’ve ever had a panic attack, you probably know that it can feel like you are losing control of your body. There’s not enough air, things start to feel unreal — you might even feel like you are dying.
Panic attacks are very common. It’s normal to experience panic in response to extremely stressful situations. However, panic attacks themselves can also become a source of stress and anxiety. People who suffer from panic disorder can go through life fearing that another panic attack is on the way, and sometimes go to extreme lengths to prevent them from happening.
Panic disorder and agoraphobia can prevent us from engaging in the most colorful and fulfilling parts of our lives. Often, the confines of panic disorder and agoraphobia can grow tighter and tighter the more we try to avoid triggering them.
Panic Attacks Are Not Harmful
Though uncomfortable, anxiety and panic are natural and usually adaptive reactions to threat, whether physical, social, or mental. They help us prepare to meet the challenges of living. As much as the physical symptoms of panic can feel life-threatening, they are really there to protect us from harm.
Panic is a function of our autonomic nervous system, which governs the fight-or-flight response. Two sub-systems (the sympathetic and parasympathetic nervous systems) work in conjunction to activate and calm this response. These two systems balance each other so that panic occurs when necessary, but doesn’t last forever. Panic cannot continue to spiral out of control indefinitely, though it’s possible to feel keyed up or on edge for a few hours afterward, due to lingering chemicals that take time to settle.
Fight-or-flight, as its name suggests, prepares the body to attack the source of danger or run away. These actions depend on the larger muscles like the thighs, heart, and biceps. Heart rate increases and breathing quickens and deepens to provide more oxygen to these muscles. This also means that blood may be taken away from extremities such as fingers and toes, and sometimes even the head. These changes in one’s breathing and blood flow are minimal and pose no danger, but they can cause feelings of dizziness, unreality, weakness, or cold. Lightheadedness, shortness of breath, and chest discomfort can also happen if oxygen is not used at the same rate it is taken in.
Other symptoms, like sweating, cool the body to prevent it from overheating and make the skin more slippery so that it’s harder to grab. Energy is directed away from the digestive system, which can sometimes cause nausea or diarrhea, as a way to get rid of material that can weigh us down.
The reason why panic attacks can sometimes happen “out of the blue” is because many of these processes can become automatic, just like when one learns to walk or ride a bike. The body may be reacting automatically to things outside of the awareness, including subtle shifts in one’s internal state. If one is afraid of having a panic attack, even things like a slightly quicker heart rate can cause a panic response.
When one doesn’t understand why these symptoms are occurring, they can be especially terrifying. Many people think they may be having a heart attack or are about to faint. But in reality, these temporary changes make us physically stronger and mentally quicker. The balance of the autonomic nervous system also ensures that the state of panic does not continue forever and we do not collapse from overexertion.
Treatment for Panic Attacks
Panic comes from interpreting certain environmental or internal signals as dangerous, creating a negative cycle where the physical symptoms of panic signal more danger, which then brings about more panic. Avoidance of these situations and physical symptoms also reinforce the fear and feed into this cycle.
Sometimes, panic attacks can also be caused by medical problems. Consult with a doctor to see if this may be the case for you. Addressing these medical problems may not eliminate the problem, but it can help.
If you or someone you know is struggling with panic disorder, it’s important to seek professional support. A therapist can help you understand your panic cycle and learn ways to interrupt it. You can learn to identify negative thoughts and develop alternative ways of thinking. Under guidance, exposure to both the physical symptoms and feared situations can teach your emotional system that these experiences are not dangerous. Breathing skills help regulate the breath and allow you to continue engaging in these activities and face those fears. With professional help, you can return to the vibrant and active person you used to be. Contact us to learn more about anxiety therapy. Written by Alice Wen, LMHC.