Although panic feels terrible, panic attacks are actually supported by activation of the sympathetic nervous system, which is associated with self-preservation.

Panic attacks feel awful.

However, despite the unpleasantness of panic attacks, we’re actually lucky to have the neural circuitry that drives them. Although it might not feel like it, panic is caused by one of your body’s most important self-protective mechanisms.

What causes panic attacks?

When we are safe, our bodies are designed to conserve resources in order to promote long-term survival. If all is going well, there is simply no need to squander a precious commodity like energy. However, whenever we are in danger and there is the potential for death or serious harm, our bodies will utilize whatever resources are necessary to guarantee that we live to see another day.

Think about a time you unexpectedly encountered a physical threat in your environment. Maybe you were peacefully gardening when you happened upon a snake. Maybe you were out for a stroll when an unfamiliar dog ran up to you with its teeth bared. Maybe you were happily picnicking in Jurassic Park when you suddenly came face-to-face with a velociraptor.

What are your options? You essentially have two:

1. Fight – You can go head-to-head with the threat in order to neutralize it.
2. Flight – You can escape the situation by evading the predator.

Regardless of which option you choose, the success of your “fight-or-flight” strategy depends on being able to mobilize yourself swiftly. The ability to instantaneously shift into high alert mode in order to deal with an imminent threat is supported by something called the sympathetic nervous system. This system helps promote short-term survival by activating your brain and the other biological systems (e.g., various glands like the adrenal gland) that are necessary for responding to threats. Secretion of chemicals like adrenaline and noradrenaline temporarily give you an energy boost, sharpen your senses, quicken your reaction times, and boost your strength (Barlowe & Craske, 2006).

Why do people have panic attacks?

Physiologically, what are the symptoms of sympathetic nervous system activation? As your body is gearing up to take action, you are likely to notice rapid heartbeat, rapid breathing, tunnel vision, trembling, sweating, frequent urination, digestive issues (e.g., diarrhea), and pupil dilation. Together, all of these symptoms are designed to work in concert to help you defeat or evade the predator (Barlowe & Craske, 2006). For example, changes in circulation and respiration increase the availability of vital nutrients for your brain and muscles. Sweating makes your body slippery, which interferes with predators being able to bite and hold onto you. Diarrhea and increased urination relieve your body of excess weight, making it lighter and more mobile. Pupil dilation gives you heightened awareness for detecting potential threats. Trembling represents energy getting redirected to large, important muscle groups that can aid in your fight-or-flight efforts.

If you experience panic attacks, these symptoms are probably all too familiar. That’s because panic and the fight-or-flight system engage the same neural circuitry. This is a very basic biological system, one that we have in common with many of our non-human relatives. As you might suspect, it originally evolved to help us deal with environmental threats, like predation. Every living, breathing human being is hard-wired with panic circuitry, as the process of panic is intended to be a natural, helpful response. In a strict biological/evolutionary sense, we’re quite lucky to have it.

Unfortunately, humans are too complicated for their own good.

In humans, the same sympathetic nervous system activation that is jump-started whenever we perceive tangible physical threats can also get activated when we perceive intangible, mental threats. That’s one of the consequences of our complex neurodevelopment.  Many of the daily threats we face have shifted from the tangible to the intangible.  Few of us encounter predators, like bears, snakes, or lions, on a regular basis. The very real dangers that might have threatened our ancestors simply aren’t relevant for most us today.

However, a reduction in tangible threats does not mean that threats no longer exist for us.  Instead of contending with physical threats to our survival, we contend with perceived threats to our well-being.  These threats can’t necessarily walk up to you and bite off your arm, but they threaten our rather complex mental lives and endanger our physical and emotional well-being. These threats include actual or potential unemployment, not getting into your preferred college, getting overlooked for an important promotion, getting a bad grade, or not passing an important examination.  Like it or not, these threats are the price we pay for having a highly-developed cerebral cortex.

For people with panic disorder, panic circuitry gets activated at inappropriate times and in inappropriate places (e.g., school, work; Barlowe & Craske, 2006). Because most people with panic are not facing physical threats, the very circuitry that was designed to be helpful actually thwarts their problem-solving efforts. It is difficult to give a speech or take an exam when you are trembling, sweating, and feeling nauseous. Because many contemporary threats yield to mental (rather than physical) solutions, excess sympathetic nervous system activation can be problematic. This is further compounded by the fact that individuals who have panic often begin to worry about when and where the next attack will occur, which can also interfere with concentration and performance.

Despite the unpleasantness of a panic attacks, the sympathetic nervous system is essential to our survival and we do not want to eliminate it.  We just want to be able to coexist with it in a way that is adaptive.

Read more about panic treatment strategies here or here, or contact me to arrange consultation or treatment in South Florida.  I see patients in Palm Beach Gardens, Jupiter, West Palm Beach, Fort Lauderdale, Miami, and other South Florida communities for panic attack- or anxiety-related issues.

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