Like a thief in the night, a panic attack can strike at any moment and without any obvious reason. Those who’ve suffered them understand that they can be a truly terrifying experience: The pounding heart, the shortness of breath, the feverish sweat, all culminating in a seemingly inescapable sense of impending doom. They can be triggered by any number of things—whether we understand what those triggers are or not—but what exactly is happening inside our bodies to make us feel like this? We asked LA-based psychologist and psychotherapist Dr. Jeanette Raymond to break it down for us.
The Increased Heart Rate (and the Trembling)
You can’t die from a panic attack, but all the symptoms together can make you feel like you’re about to have a heart attack (or at the very least, faint). That’s because your body floods with adrenaline at a time that apparently makes no sense: You undergo all the stress of realising you’re about to drive off the edge of a cliff, only while sitting safely on your couch at home. So where does all this adrenaline come from?
According to Raymond, panic attacks can be caused by your brain’s ham-fisted attempts to protect you from things you don’t want to acknowledge. It’s essentially a distraction technique, where you’re forced to stop thinking about, say, the 50-page manuscript due on our bosses’ desk in two hours because now, you’re worried that you’re having a stroke instead (real helpful, brain, thank you).
Once that adrenaline is released, “Our body goes into fight-or-flight mode,” says Raymond. “We can’t run away from ourselves, so flight is out of the question, which means our body gears up to fight.”
When your body enters into fight mode, it resorts to one of the earliest methods of survival—increasing your heart rate to provide your muscles and limbs with the excess energy (in the form of blood) they need to keep predators at bay. End result? The feeling that your heart is pounding through your chest and about to burst. That instant rush of blood is also what stimulates the nervous system to increase your reaction time, which in this case, has the effect of causing your limbs to tremble uncontrollably.
The very same fight response that sends your heart rate soaring is to blame for the sweatiness you often experience during a panic attack. It’s a side effect of the adrenaline in your bloodstream: It prepares your muscles for exertion, but also causes you to perspire. While no one’s really sure why adrenaline makes our pores leak, a 2011 study suggests it might be a survival method we developed to warn others of imminent danger. During the study, the researchers found that those exposed to the smell of another person’s sweat stress felt more alert across the board—a state that could help them spot an incoming enemy they may have otherwise missed.
The Shortness of Breath (and the Disorientation)
The fight response is also to blame for the feeling that you can’t catch your breath. The increase in heart rate—and the heavy flow of blood to your extremities—requires extra oxygen to keep all of that blood oxygenated, leading you to feel short of breath. In an attempt to get more oxygen to your blood, you begin to hyperventilate, which, as Raymond warns, “actually causes dizziness and disorientation.” That’s because you end up breathing so much carbon dioxide out of your system that your brain essentially ODs on oxygen, causing you to become lightheaded. Sometimes this even affects the way your brains perceive things, leading to the sensation that the world is starting to close in on you.
While panic attacks are just your body trying to help (and failing miserably), they’re still terrible. Fortunately, it is possible to get the better of those symptoms if you know what to do. According to Raymond, “The best way to calm down during a panic attack is to focus on your immediate surroundings. Do a reality check: Look around, and realise that you are in no real danger. While you’re doing that, take long, deep breaths [psychologists recommend holding each breath in your lungs for three seconds before releasing it]. Not only will they help relieve your shortness of breath, research also shows that deep breathing calms the amygdala, or the fear center of the brain.”
The best way to deal with it, of course, it to avoid getting to that level of anxiety in the first place. If you frequently experience panic attacks in the same place—say, on the train into work, or standing in line at the grocery store—distracting your brain from the fact that you’re back there again can help stop the anxiety from taking over. Even something as simple as listening to a calming song or playing games on your phone can be enough to keep the panic at bay. Unless you really are about to drive off the edge of a cliff, at least, in which case, you’ve probably got bigger things to worry about.