Fight or Flight response explained

Like I described earlier, the purpose of the fight-or-flight response is to give you the best possible chance of survival when you encounter danger.  One of the first things that happens is an increase in your heart and breathing rate.  These are beneficial for either fighting or fleeing - your lungs take in more oxygen and your heart pumps faster to deliver that oxygen to your muscles so you can punch harder or run faster.  At the same time, your body doesn't want to waste energy on anything that isn't immediately important to your survival.  So it completely shuts down your digestive system, and not only that, it doesn't want you to have any extra weight while you are running away from your attacker.  So whatever food or liquid you have in there needs to leave ASAP.  It also redirects blood flow away from your limbs so that if your arm is ripped off there is less blood loss.  Your sweat glands are turned on so you are nice and slippery to make it harder for your attacker to grab you.  Your pupils dilate so that you can better see your attacker's next move.  Okay so that all makes sense if you are trying to run from a bear.  What if you are just sitting in a restaurant?  What does it feel like?

You notice that your heart is racing.  It is extremely uncomfortable and you wonder what is wrong.  Your breathing rate increases - which you might not notice but you do feel a side effect of your accidental hyperventilation: feeling lightheaded and dizzy.  Your body turns off your digestive system so now you feel nauseous and maybe like you need to throw up.  Your body redirects blood away from your limbs - so now your arms and legs start to feel tingly or numb.  You start to sweat heavily.  Your pupils dilate and this screws up your vision - either making your peripheral vision blurry or maybe blocking it out completely giving you tunnel vision.  Your senses also become extremely heightened.  Every noise seems louder, smell seems stronger.  And I don't know if I have read this anywhere but just from personal experience I also know that you lose the ability to think rationally.  Your body has just initiated this ancient animalistic program and there is not very much room for you to use your brain and think clearly during this fight-or-flight response.  The only objective is to survive by fighting or running away.

So suddenly you get really sweaty, your heart is racing, you feel lightheaded and nauseous, your vision is blurry, your legs are numb and at the same time your mind is screaming at you to "run".  The only problem is that you are not faced with an attacker.  You are not about to protect your child from a tiger.  You are sitting quietly at a restaurant minding your own business.

So how did this happen?  Maybe you were in my position, where you skipped lunch and had really low blood sugar.  So you start to feel lightheaded - your brain needs sugar,  and it is politely suggesting that you eat something relatively quickly.  And you accidentally misinterpret this suggestion.  You instead start to worry: "What is happening to me?  Something is wrong" and with that fear, your amygdala wakes up and says "Oh there must be danger here!" and presses the ON button, initiating the fight-or-flight response.  As you are wondering what is wrong with you, you start to get more "symptoms".  Sweaty, heart palpitations and tunnel vision.  And you start to worry even MORE: "What is happening to me?!"  Your amygdala sees that wow, there is a LOT of danger here, obviously it did not give you quite enough adrenaline so it presses the ON button again.  Now you feel dizzy and nauseous and your legs are numb.  And now you are completely distraught and think you are about to die because your whole body is in chaos.

The good news is that you are not about to die.  As awful as it feels, your body is actually trying to protect you.  Your body was designed for exactly this type of response.  Think back to the days of our ancestors living on the plains.  They probably had to watch out for lions and other predators every single night.  They probably had this fight-or-flight response go off several times a day for their entire life.  It will not hurt you.  Your amygdala sensed danger and it is doing the best job it can to prepare you to survive. 

So you are sitting at a restaurant and you feel all of these symptoms.  And you don't realize that it is your amygdala trying to protect you.  You think that something is seriously wrong and your body is falling apart.  You think that you might pass out and die.  You are scared of the increased heart rate, at the dizziness and numbness.  You are scared because your vision is blurry and you feel like you can't breathe.  And your amygdala, wanting to always protect you from danger, remembers all of the details about this event.  It remembers that increased heart rate = danger.  It remembers that dizziness = danger.  It remembers the name of the restaurant, the position you were sitting in when you started to feel dizzy, who you were with, what you were wearing and what you were thinking.  It is trying to do a good job of remembering all of this information so that next time you are faced with this same "danger" it can press the ON button and protect you. 

There is one problem.

This "danger" that the amygdala has now cataloged and stored is the very same physiological response that it uses to protect you.  Your amygdala now thinks that the fight-or-flight response = danger.  And what is literally the ONLY thing that it can do?  Press the ON button again. 

What is a panic attack?

A panic attack is actually a completely normal physiological response.  It is otherwise known as the "fight-or-flight" response or an adrenaline rush.  This same biological response occurs if you are in a near-car accident or are hiking in the woods and run into a bear and her cubs.  This response has evolved to protect you by either preparing you to fight, or preparing you to run away from the danger.  The key to a panic attack is that this response comes at an inappropriate time.  You have this huge adrenaline rush and a feeling of intense fear....but maybe you are just sitting on your couch.  Or at a grocery store.  There is no bear, there is no car accident.  And so you can only assume that something terrible is happening to your body.  You must be having a heart attack or brain aneurysm.

Your first panic attack was probably a combination of a variety of biological and psychological factors that happened to all peak at the same time.  For me, 1)  I have always been a bit of a hypochondriac.  Growing up, if I had any physical symptoms I would immediately look them up on the internet and worry until they went away.  In this way, I probably just happen to have some personality characteristics that make me more prone to anxiety and panic attacks.   2)  The weeks leading up to my first attack I had a variety of life changes: I graduated from college, I left all of my friends and moved back home, I was about to start a new job, my boyfriend and I broke up, I was about to take the GREs, my grandpa had just passed away.  And although I didn't consciously feel any stress about this, looking back I know that I was probably more vulnerable to anxiety because of this combination of events.  3)  At the same time, the day of my attack I had a huge breakfast and then knowing that I would be having an early dinner, I skipped lunch.  Well the dinner kept getting pushed back and back and so I probably had incredibly low blood sugar at the time of my attack.  Taking all of these factors into account when I felt myself becoming lightheaded from the low blood sugar, combined with the anxiety I probably felt about everything that was happening in my life and my predisposition to health anxiety, I misinterpreted the signals that my body was giving me.  Instead of thinking "Oh, I probably should eat something I'm not feeling too well" I responded with fear: "What is happening to me?!" and thought that I was about to die. 

There is a region in your brain called the amygdala.  It is a very primitive part of your brain and one of its important jobs is to press the "on" button to turn on your fight-or-flight response.  It has evolved to protect you from danger, and importantly it has the ability to learn what is dangerous.  Just say you are hiking and you encounter a bear and its cubs.  You are not an experienced hiker so you don't understand the danger of approaching the trio.  So you go ahead and try to pet one of the cubs.  The momma bear rears up on her hindlegs and roars ferociously.  Your brain then decides the best thing to do is to run away.  The amygdala does its job and presses the "on" button, turning on the fight-or-flight response and you are luckily able to flee your attacker.  The amygdala then stores all of the important information from this event so that next time you see a bear, you will feel fear and remember the danger involved.  It is a response designed to protect your life.  Unfortunately, the amygdala is pretty stupid so it doesn't really know what counts as "important" information.  So it will store information related to the bears but also related to the weather, to what you are wearing, what you were thinking at that moment and who you were with. 

Coming back to my panic attack, I became very afraid because I did not know what was happening to me.  In response to this, my amygdala immediately woke up and turned my fight-or-flight response on.  Unfortunately this made matters much worse.  To understand why, lets look at the details of a fight-or-flight response....

What is panic disorder?

Panic disorder is somewhat like an allergic reaction:  Just say you are allergic to peanuts.  You actually do not have an allergic reaction the first time you have a peanut.  It is only with the second and subsequent times that you are exposed to peanuts that you experience a bad reaction.  Panic disorder (in its typical form, I guess) follows this same pattern.  The first time you have a panic attack you are absolutely terrified for your life and don't know what is happening to you...but then it ends.  You survived.  You do not have panic disorder.  It is the next time, or next few times when you realize that this horrible experience, this feeling of being out of control, not knowing what is happening to you comes at you again and again.  And the timing is completely unpredictable.  And you are worried about when the next attack is going to come and how bad it is going to be.  That is panic disorder.

I had my first panic attack at a restaurant.  I had this horrible sense of impending doom, I started shaking and felt really dizzy.  My vision started to go out and I thought I was going to die.  I had no idea what was happening to me but it was unbelievably scary and confusing and terrible.  I somehow made it home and laid on the couch where I went between periods of extreme cold and extreme heat while visibly shaking uncontrollably.  My heart was racing.  I felt like I was going to pass out cold at any second.  That night I could not sleep at all.  Every time I would start to feel tired, I think my body interpreted it as passing out – a bad thing rather than just normal sleep - and I would have another wave of intense fear and heart palpitations and shaking.  But over the course of the next few weeks I went to the doctor, got checked out and found out that what I most likely experienced was a panic attack.  After a while I was able to get back to complete normal.  I'm talking absolutely completely normal.  

That lasted for about 3 months.

My second panic attack was in a theater.  I was sitting in almost the exact middle, with at least 5 people on either side of me.  I had the same wave of intense fear, my head hurt, my vision was blurry and I left the theater and went home.  After some time I realized that no, I was not having a medical emergency, this was actually another panic attack.  I could not believe that this was happening to me again.  I thought that little panic attack episode was way behind me.  I did NOT want to feel like that ever again.  I would therefore avoid any place or activity that would make me feel that horrible and that scared.  That is panic disorder.

Purpose

I started this blog because I know how it feels.
I know how it feels to be utterly consumed by anxiety.
To suffer from daily panic attacks.
To feel like no one understands what I am going through.
To feel angry, ashamed, alone.

When I got to a point where I was barely functioning in my daily life, I knew that I needed help.  And I was lucky enough to have the capability to get myself help in the form of cognitive behavioral therapy with a psychologist that specialized in treating panic disorder.  I know that many others are not this fortunate.  Treatment costs a lot of money and there are only a few good experts in the field.  I want to share my experience and the skills I have learned with other sufferers of anxiety and panic disorder.  I know what it is like to search the internet for treatment answers, and to read through a website that sounds really promising, only to get to the bottom of the page and be expected to pay $500 for help.  I don't want to make money off of someone's suffering.  I know how bad it can feel and I don't think anyone should have to feel like that.  Hopefully I can show you how to move in the right direction and realize that anxiety and panic does not control you.  This disorder does not have to ruin your life.