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....
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