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You know that feeling you get just before you die? Of course not, or you would not be reading this article! Yet, this is a common symptom of a panic attack, the fear that one is dying or losing control accompanied by various uncomfortable body sensations (shortness of breath, rapid heart beat, chest tightness, nausea, shaking, chills/sweating, dizziness/light-headed, etc). We know that people do not die or “go crazy” from having panic attacks. Nevertheless, it feels 100% real at the time.
There is a reason for this.
When we have a panic attack our brain and body go into instinctual/survival mode. The name for this is fight, flight (or freeze) response. Simultaneously our thinking/reasoning brain goes offline.
The brain in fight, flight response.
Our amygdala, also called our primitive brain, is responsible for processing fearful and threatening stimuli. When detected, it sends a message to our hypothalamus that there is a danger and the body must prepare quickly to respond and survive. The hypothalamus sends a message to our adrenal gland, which then releases two valuable body hormones, adrenalin and cortisol, to give us the urgency and strength to survive a threat. This is the sudden whoosh of uncomfortable sensations during a panic attack and why the situation feels real. It is because our body is reacting as though there is a real threat to our lives even when there is not.
This brain function is why we are here today as a human species. It has kept us alive. Think back to the time of hunters and gathers, there were many regular threats like wild animals and natural conditions. When a dangerous situation presented itself, the brain went to work and sent the signal to fight, flight, or freeze. Those body chemicals gave us extra strength and even helped us survive serious injuries.
Adrenalin and cortisol can be helpful today when there is a real threat like a house fire. The problem is when your brain goes into fight, flight mode and there is not a real threat. Essentially, the brain receives and distributes the wrong message.
Our brains are changeable.
This ability to change is called brain plasticity. We once thought our brains were set by young adulthood. We now know the brain’s structure and function, including response to feared stimuli, can continue changing with age. Cognitive behavioral therapy (CBT) and mindful practices have been shown to positively change our brain’s neuropathways.
Interesting facts.
The majority of us will have a panic attack at some point in our lives.
Panic attacks are not within themselves harmful to our bodies.
People can have a panic attack and it can go unnoticed by those around them.
You can still function (walk, talk) during a panic attack.
Panic attacks are short-lived and generally last a few minutes to 20 minutes.
Panic attack versus panic disorder.
One can have panic attacks and not be very bothered by them nor fear them recurring.To have a panic disorder, one must fear panic sensations and recurring panic attacks and engage in avoidance (situations, places, & sensations) behaviors.
Those who develop panic disorder may have a predisposition (hereditary), traumatic or stressful life experience(s), and/or an imbalance of brain chemicals (which is believed to have an effect on anxiety sensitivity).
Panic disorder is highly treatable!
Cognitive behavioral therapy (CBT) is an effective treatment for panic disorder and by treating panic disorder people often see a decrease in overall anxiety. In this therapy, one learns all about anxiety and how it functions, including the anxiety cycle, how your thoughts affect your emotions (fear/anxiety), and behaviors (avoidance). This is called psychoeducation.
One will also learn to recognize what thinking traps they are engaging in and how to challenge and restructure them to reduce anxiety.
Another important part of therapy is interoceptive exposure. This is the behavioral part of CBT and, in my opinion, an imperative piece of therapy. Interoceptive exposure works by intentionally and gradually exposing oneself to feared body sensations. The brain then becomes used to and comfortable with body sensations once feared or found discomforting.
If you have panic disorder and are ready to start therapy, look for someone who specializes in CBT for anxiety disorders and incorporates interoceptive exposures.
You should be in the driver’s seat of your car, not your anxiety.
