What Causes Panic Attacks?

Clinical Reflections on Psychological Trauma,

Depression, and the Symptoms of Anxiety Attacks 

 by Gregory E. Hamlin, PhD

Number GH-02 of free online journal articles 

Understanding Causes Begins with Mapping the Symptoms of Anxiety Attacks Within Your Emotional Terrain

Understanding what causes panic attacks is like being lost in a thickly-wooded forest and then taking the first constructive action to get back onto the main trail: You reach in your backpack and pull out that sweaty, crumpled trail map. It seems more important to find a way out than to understand the causes of being lost.

A good map is like a security blanket to me. If I wander off the trail above the timberline (10,000 feet) and feel lost, I regain my confidence just knowing that I have this piece of paper in my hand called a map. The human brain has a high need to feel oriented to space, time and seeing the meaning of the present situation. So overcoming panic attacks begins with factual information that functions like a mental map or picture for us to get our bearings.

A talented painter can make us "see" rolling hills of pastures and grazing cattle by using some well placed lines and brush strokes. In a similar way we can start to gain a sense of control just by knowing the facts about what is happening to us. Painting a picture of panic attacks can be a bit more complex because how a panic attack affects you is as unique as you are. But gaining control of what causes panic attacks can get a good start by making a map of the symptoms of anxiety attacks within our own emotional landscape. This isn't a simple black and white landscape. It consists of various combinations of brush strokes and confusing shades of gray. Panic attacks can even be frighteningly colorful and feel like the most horribly 3D experience of your life. 

Although some physical symptoms may be similar, they will differ in duration, intensity and combination. Think of it: two people can each have a panic attack and not share any one of the symptoms of anxiety attacks in common. How can this be?

At panic attack is often a small cluster of symptoms that intensify to the point of being overwhelming...even traumatic. Panic attacks involve a smörgåsbord of symptoms in which each panic sufferer partakes of a different combination of the of the items in the panic buffet. It's easier to find enough control to put an item on your tray back into the food display if you know what it is! If 10 people were at a dinner talking about their own panic attacks, it would be difficult to find even one other person whose configuration of symptoms mirrored their own. 

 A Straightforward and Practical Definition of a Panic Attack

 “Suddenly, out of nowhere, I felt like I couldn’t breathe. My heart was racing and I felt sick. I couldn’t move…” This is a typical comment by someone describing a panic attack. Many people speak of panic attacks when they simply mean that they were startled, anxious, or afraid. But panic attacks actually have a clinical definition. A panic attack is generally defined by any four of thirteen symptoms that intensify and peak during a short period of time.   

According to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), when 4 or more of the following symptoms of anxiety attacks develop abruptly, reach a peak within 10 minutes and create intense fear or discomfort, you are experiencing an 'official' panic attack. 

1. palpitations, pounding heart, or accelerated heart rate 

2. sweating 

3. trembling or shaking 

4. sensations of shortness of breath or smothering 

5. feeling of choking 

6. chest pain or discomfort 

7. nausea or abdominal distress 

8. feeling dizzy, unsteady, lightheaded, or faint 

9. derealization (feelings of unreality) or depersonalization (being detached from oneself) 

10. fear of losing control or going crazy 

11. fear of dying 

12. paresthesias (numbing or tingling sensations) 

13. chills or hot flushes 

 

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