Everything happens in an instant: the heart pounds like a jackhammer, the body tightens as if in a corset. Dizziness, shortness of breath, and terrifying thoughts can feel so unbearable it seems like you’re dying, even though you’re physically healthy.
About one in three people will experience at least one panic attack in their lifetime. The term refers to an excessive reaction of the body to perceived danger. “The typical response is ‘fight-or-flight-freeze.’ The body and mind are trying to protect you in response to an anticipated threat,” explained clinical psychologist Reid Wilson in an interview with Popular Science. He is the author of the book “Don’t Panic: How to Take Control of Anxiety Attacks.”
How Does the Body React to Panic?
When a person perceives an external threat through their five senses, the thalamus, which processes those sensations in the brain, sends a specific signal. That signal travels deeper into the brain, reaching the amygdala — a tiny cluster of neurons that serves as the main arbiter of fear and avoidance. The amygdala interprets the message and sends a distress signal to the hypothalamus, the control center for involuntary body functions like breathing. The hypothalamus then directs a chemical SOS to the adrenal glands, prompting them to release cortisol and adrenaline into the bloodstream.
“This triggers a cascade of changes throughout the body. Consciousness no longer controls the situation,” says Wilson.
For example, if a lion were attacking you and the difference between life and death were measured in milliseconds, there wouldn’t be time to weigh options. Your body makes the decision for you. Your pupils dilate. Breathing and heart rate quicken. The mind narrows into hyper-focus. Blood is redirected away from less critical areas like the fingers and toes.
For a long time, scientists thought this chain of fear triggered by external factors was the same for all types of panic, with the amygdala driving every fear response. Recent research, however, shows the amygdala’s behavior depends on context.
Fear triggered by bodily sensations, such as shortness of breath, can also cause panic attacks. That helps explain why panic can sometimes seem to come out of nowhere.
How Breath-Holding Triggers Panic
Maybe after a stressful day you suddenly notice you haven’t taken a deep breath in a while. In some cases, the amygdala does the opposite of igniting fear: it tries to suppress it, and in doing so it can block breathing.
This is called amygdala-induced apnea. During this state, people hold their breath without realizing it, which can trigger a cascade of panic symptoms as the body reacts to the threat of suffocation.
This is part of the freeze response. Over the course of evolution, humans developed the ability to unconsciously hold their breath when survival required extreme focus.
Throughout the day, various triggers can activate a person’s amygdala, leading to breath-holding, increased CO₂ levels, and an imbalance in the chemoreceptor system — the sensory cells that detect changes in blood composition and send information to the brain to keep the cardiovascular and respiratory systems in balance.
A sudden spike in CO₂ from unintentional breath-holding can be enough for chemoreceptors to send an alarm to the brain and trigger a panic attack.
How to Cope with Panic
Reduce alcohol and caffeine intake, exercise, and get enough sleep to support your nervous system, but remember most strategies for managing panic focus on changing how you respond to your thoughts and sensations.
Above all, learn to breathe more evenly and mindfully. CO₂ levels should not be too high or too low; both extremes can provoke anxiety.
A serious risk for people who regularly experience panic is agoraphobia. Panic disorder with agoraphobia can develop when people unconsciously start avoiding situations they think might trigger an attack, shrinking their world.
Getting angry at yourself for feeling anxious doesn’t help. The goal isn’t to prevent every future attack but to build confidence in your ability to handle stressful situations.
“Accepting physical sensations during panic is a therapeutic intervention. Develop a readiness to experience symptoms rather than avoid them. You can do this while shifting the internal dialogue in your mind,” Wilson says.
Thinking “I can’t handle this” breeds anxiety and avoidance. A more helpful approach is: “I don’t like this, but I can handle it.”
Photo: Openverse
