Panic attacks are triggered by stress.

In fact, panic attacks are a result of an elevated stress response.  A response to events that happen right now, and possibly events that happened a long time ago.

Understanding panic attacks

How do you know you are having a panic attack?

If you have ever had one before, you recognize them instantly.

  • Physical symptoms: Shortness of breath. Accelerated or irregular heartbeat. Chest pains. Dizziness. Nausea. Shaking.
  • Psychological/emotional symptoms: Disorientation. Fear. In extreme cases, feeling you are going to die.
  • Post-attack reaction: Fear of the next panic attack.

Panic attack triggers in the present

Panic attack triggers can seem small and insignificant. But to the person who experiences them, they carry a hidden signal of danger. This signal of danger is the actual panic attack trigger.

The panic attack trigger can be a sound or a smell. Sometimes it can be an interaction with another person that signals danger. For example, an angry argument or a feeling of intimidation or abandonment might set off panic attacks.

Another kind of panic attack trigger can be an underlying fear of open spaces (agoraphobia) or small, enclosed spaces (claustrophobia).

Clearly, there are many other kinds of panic attack triggers. What they all have in common is a subtle change in the environment that signals danger to the person who suffers from panic attacks.

What happens next is an overstimulation of the human stress response system. The famous fight-or-flight response.

Your body gets ready to fight an invisible tiger. Part of the stress comes from the fact that this tiger is elusive, and that your system spends a lot of energy trying to locate the danger.

When you have a panic attack, your fight-or-flight response doesn’t naturally decrease when the trigger disappears. It continues on for much longer and sometimes gets worse as it goes on.

If you have a lot of panic attacks in a short time period, the triggers can get smaller and smaller.

Panic attack triggers from the past

The reasons why panic attacks can be so difficult to shake off, often lie in the past.

Panic attack triggers tend to contain, within the signal (the sound, the location, the interpersonal situation), a message from the past, and trigger memories of dangerous situations. These are memories that we are sometimes not fully aware of, but that have been ‘marked for danger’ by our brain.

It is important to understand that the panic attack triggers often point to dangers that don’t really exist, or that are much smaller than the panic reaction suggests.

For example, you hear a random sound that is somehow connected to a frightening incident in the past. That sound probably comes from a different source, and there is no direct connection with you. But because of the fear you experienced in the past, your stress response activates. And because you can’t do anything about it, the stress response increases because you have taken no action.

Coping with panic attacks

  • What to do in the moment
    • Understand that panic attacks are not a sign of a serious physical illness. As many sufferers say: “It feels as if you are going to die, but you are not going to die.”
    • Know and understand the symptoms.
    • If you can, identify the trigger.
    • If you can, continue your normal activities. This signals to your stress response that the danger is manageable.
    • If you need to, take a break and find a quiet spot.
    • Remind yourself that this is a panic attack, not a heart attack.
    • Try some basic breathing techniques, like the 5/5/7 method. Breathe in for a count of 5, hold your breath for a count of 5 and then breathe out for a count of 7. Slow breaths will calm down your stress response. They signal that the danger has passed. Take as much time as necessary.
    • Try to make a note of the panic attack trigger and what you did to calm down.
  • What to do in the long term
    • Panic attack triggers happen in the present. The causes of panic attacks usually lie in the past. Therefore, counseling and psychotherapy are the best treatment. With your therapist, you can explore the triggers and investigate the signals from the past they carry. You can then find solutions to long-term fears and process traumatic incidents from your life history.

Panic attacks are frightening and can interfere with your life in major ways. Seek professional help soon! The treatment of panic attacks is usually successful.