By Jennifer Copley (Last Updated 24 January 2015)
A panic attack occurs when the body’s natural fight-or-flight mechanism gets triggered in response to nonthreatening situations.
Throughout most of our history, the fight-or-flight response helped us survive by mobilizing us to escape from predators, aggressive humans, or dangers posed by the environment. However, in the modern world, the majority of threats are psychological rather than physical, so people with an effective fight-or-flight response may suffer from attacks of panic that are no longer useful for survival. The following are some common triggers for panic attacks.
Imagining Threatening Situations
When you imagine some terrible, catastrophic event, your body will often respond as though the event is actually happening, generating the fight-or-flight response as a false alarm. When you have a panic attack, your body experiences a surge of adrenaline that would normally be put to good use – fighting or escaping. In an actual life-or-death situation, you’d be far too busy to notice all the nasty sensations associated with the adrenaline surge. However, when you must simply stay still and behave as though nothing is happening, you’ll notice all sorts of unpleasant symptoms, and worrying about them tends to magnify the fear.
Because the fight-or-flight response is adrenaline-fueled, cardio exercise is a highly effective treatment for panic attacks. Working out enables the body to do what it desperately wants to do – run, jump, swim, or otherwise move rapidly to escape a perceived danger. Unfortunately, some people find the heart rate increase during cardio exercise frightening, but if they push through this fear, they find relief on the other side (there are a few medical conditions that preclude cardio exercise – although it’s great for the majority of panic sufferers, check with your doctor beforehand to be on the safe side).
Misinterpreted Emotional Responses
People with panic disorder may have a phobia of internal physical sensations so that their alarm systems are easily set off. In some cases, they may mistake physical responses associated with psychological feelings for symptoms of illness or a response to real danger. This can trigger their alarm systems in situations that are not physically threatening.
Suppressed or misidentified emotions may set off a false fight-or-flight response because they trigger sensations similar to those of panic or physical illness. For example, when a person is angry, her heart rate rises; if she is not acknowledging the anger or is misinterpreting it, she may believe that this is a symptom of a heart attack rather than an emotion.
Major Life Stressors
Stressful life events or situations (anything that causes a feeling of threat) are a common cause of panic attacks, particularly in those who have an increased risk for developing panic disorder because they have a close relative who suffers from the disorder (many experts believe that people can inherit a genetic predisposition to have panic attacks in response to stress).
Stressors that may contribute to the development of panic disorder include:
- The loss of or separation from a loved one
- Being trapped in a bad situation (for example, a negative relationship, job, or home that the person can’t leave or believes he can’t leave for some reason)
- Being in a stressful caretaking role
- Moving house/moving to a new city
- Changing jobs
- The birth of a child
- Any other major life transition
Most people have their first panic attack after several months of prolonged stress.
Poor Breathing Technique
People who suffer panic attacks tend to breathe quickly and shallowly, particularly when feeling anxious, and they are prone to hyperventilation. This reduces the amount of carbon dioxide in the body, triggering symptoms such as dizziness or light-headedness, numbness, tingling, nausea, and other problems associated with panic. The mind may then interpret these symptoms as a serious health problem or a reaction to a real physical threat and spiral into panic. This is why calm breathing techniques are so effective against anxiety and panic.
Poor sleep can trigger a variety of problems, including contributing to a tendency toward anxiety and increasing the risk of panic attacks. To make matters worse, anxiety can disrupt sleep (some people even have panic attacks in their sleep that wake them up), which creates a vicious cycle of increasing exhaustion and anxiety. Lack of sleep can also contribute to conditions such as migraine headaches that make anxiety worse.
It’s probably not a coincidence that the prevalence of anxiety disorders has increased as levels of physical activity have decreased. In the past, many jobs and chores required intense physical labour, and children spent a lot of time running around outdoors. Today, in many countries, the majority of work is done at computers and our leisure time also involves sitting in front of a computer or television set.
Being inactive increases the risk of suffering from panic disorder, so it’s no surprise that regular cardiovascular exercise is a highly effective anxiety remedy. Exercise reduces the likelihood of panicking in two ways. First, during an actual panic attack, it allows the body to do what it desperately wants to do – run, jump, swim, or otherwise move. A panic attack occurs when the body’s fight or flight response is activated in response to nonthreatening situations; exercising uses up the extra adrenaline in the system that contributes to the nasty symptoms associated with the attack. Regular exercise also reduces the likelihood of suffering attacks in general by improving fitness, breathing, self-esteem, confidence, sleep, mood, and resilience.
Alcoholism, smoking, drug abuse, and coffee consumption may trigger panic attacks, as can various medications, including steroids, certain asthma medications, cold medications, diet pills, and anything containing caffeine. Withdrawal from certain medications (especially those with a tranquilizing effect) can also trigger anxiety attacks, which is why it’s important to taper off from sedating medications slowly under a doctor’s supervision.
Nutritional factors may also play a role in panic disorder for some people. Poor diet has been implicated, and deficiencies in certain vitamins and minerals may be a factor in some cases as well. In addition, some people are very sensitive to food additives, particularly aspartame, MSG, and artificial dyes, so these may also play a role.
Sugar is a common cause of problems for those who are panic-prone because eating sugary foods (particularly on an empty stomach) can cause blood sugar to spike and then crash, triggering hypoglycemia. Symptoms of hypoglycemia, which include nervousness, dizziness, heart palpitations, trembling, and sweating, are similar to those of panic attacks and so can easily cause an attack. If you do eat sweets, eat something healthy beforehand, and in an emergency where the only food available comes out of a vending machine, look for things that contain nuts, oats, whole grains, or other more healthy ingredients rather than eating pure chocolate, nougat, or candy.
Childhood Trauma, Abuse, or Neglect
Trauma, abuse, and neglect all increase the likelihood of suffering from an anxiety disorder in adulthood. Lazenbatt’s (2010) research review indicates a high correlation between abuse and severe anxiety disorders, including post-traumatic stress disorder and panic disorder.
However, it should be noted that many people with anxiety disorders were not abused or neglected as children, and many victims of abuse or neglect do not develop anxiety disorders. Although childhood suffering increases a person’s vulnerability to anxiety, it is not the only causative factor.
Over-Responsiveness to Benign Body Symptoms
People with panic disorder tend to be overly sensitive to subtle body changes or activities and misinterpret them as signs of illness. For example, they may believe that a change in heart rhythm (for example, increase in heart rate) suggests an impending heart attack, even though these symptoms have many benign causes (such as physical activity or emotional response) and are usually physically harmless. This overreaction to internal body activities can reach phobic levels.
However, some genuine physical illnesses, such as heart conditions, asthma, hyperthyroidism, and a few others can cause panic attacks. Although most people who suffer from panic disorder are in reasonably good physical health, it’s important to consult a doctor if you experience symptoms to rule out any medical conditions that require treatment.
For more information on panic disorder, see:
- What Is Panic Disorder?
- What Are the Symptoms of a Panic Attack?
- What Treatments Are Available for Panic Attacks?
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- Wilson, R., PhD. (1996). Don’t Panic: Taking Control of Anxiety Attacks. New York, NY: Harper Collins Publishers, Inc.