by Andrew Thorn

Created on: December 03, 2009   Last Updated: February 02, 2012

In a panic attack, a person is hypersensitive to an unreal threat. Perhaps as a consequence of some previous distressing incident which has resulted in a chronic avoidance or a perpetual sense of being out of control.
Panic attacks share the same physiological system that creates both anxiety and excitement arousal. The release of adrenaline into the system and the vasoconstriction of secondary organs produce either a sense of euphoria or extreme distress depending upon the interpretation of the situation. The trigger for a panic attack can often be insidious but will aggressively nudge our thinking patterns into a survival state, known as 'fight or flight'. The physical sensations created by this change and the psychological overdrive now engaged sends our thoughts racing: 'I'm having a heart attack!', 'I'm going to go crazy!', 'I'm going to make a fool of myself!', 'I'm going to faint' are just some of the more common beliefs reported by panic sufferers. Physically, the sensations escalate at a rapidly increasing rate over what seems to be an incredibly short period of time. A sufferer will then extrapolate that rate of symptom increase into the future and come to the conclusion that at some imminent future point (usually seconds or at most, minutes), they will die, go mad, explode, go crazy, kill someone etc. It seems not unreasonable then, that given this scenario, a person may feel the need to take aversive action. Whatever it takes will suffice; for some this might mean a rapid departure from the scene, whilst for others it may involve medications, breathing into a paper bag, alcohol.

What is certain is that nobody experiencing that degree of distress will choose to do nothing at all. Hence, the formation of the belief, 'If I had not (run away, taken tablets, had a drink etc) then I would have (gone mad, died, gone crazy etc). This is why it is important to recognise the existence and the role of safety behaviours in the maintenance of panic disorder. Safety behaviours are those patterns of activity that we all employ as rules to keep us safe. They are however, exactly the same patterns of activity that prevent us from ever knowing that Panic attacks have a similarly rapid retardation effect after as little as 30-45 minutes. The key therefore to conquering panic is understanding of the physical and psychological mechanisms at play and enough mindfulness and personal support to believe that whatever the experience of panic throws at a sufferer, it can do

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