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What exactly causes a panic attack???
May 5, 2007

Can you tell me what exactly causes a panic attack?

Response from Dr. Frascino

Hi,

Realizing that we still have Dubya to deal with for the next 1.5 years? Or perhaps even worse, realizing that if Dubya gets impeached or starts abusing alcohol and other substances again, Cheney, the Evil Lord of Halliburton, would be President!

However, I'm sure what you really want to know is the medical mechanism causing panic attacks, right? OK. Anxiety activates the body's "sympathetic" nervous system, which controls our "fight, flight or freeze" reaction in response to danger. Anxiety is deactivated by the "parasympathetic" nervous system, which is responsible for the "rest, relax and digest" response. These are reciprocal systems (like yin and yang) that respond chemically to outside influences and stimulate behavioral reactions via the chemicals they produce. In essence, it's a feedback system.

This feedback loop is important, because it explains how normal worry and concern can escalate dramatically into a full-blown panic attack. In this case, the anxiety response, once activated, becomes self-reinforcing as additional neurochemicals are produced by the anxious person's brain. Ideally, once the danger or threat has passed, the brain signals the parasympathetic nervous system to send out chemicals that neutralize the anxiety-related chemicals and reset the system. However, in a panic attack, the system gets stuck in sympathetic ("fight, flight or freeze") overdrive.

I know that's a bit complex, but you asked! Don't let the complexity of my response make you panicky, OK?

Dr. Bob



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