Panic Attacks
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What Causes Panic Attacks & Panic Disorder?

Daniel Sher, MA, Clin Psychology
What Causes Panic Attacks & Panic Disorder?

Panic attacks - and panic disorder - are debilitating mental health issues. During a panic attack, it can feel as though you're about to die, and the experience can be so emotionally draining that it causes you huge amounts of fear and anxiety that can drastically affect your day to day life. What’s the difference between a panic attack and panic disorder? Anyone can experience a panic attack, but a person with panic disorder experiences them frequently and they develop a powerful fear of having subsequent attacks.

Yet what is perhaps most interesting (and also terrifying) about panic attacks is that they often seem to occur out of nowhere - with no previous signs of anxiety, and no traumatic event triggering your symptoms. So what triggers panic attacks, and are there people that are more likely to get panic disorder? In this article, we'll discuss some of the causes of panic attacks, along with a few other theories about why some people may be more prone to panic than others.

Panic Attack Causes

Heredity/Genetics

A study among identical and fraternal twins completed by the Anxiety Disorders Clinical and Research Unit at the University of Milan showed that 57% and 43% (respectively) of those with panic attacks also had siblings with panic attacks. Another study showed that as much as 40% of the risk for panic disorder is genetically based.

Now, it should be noted that it's unlikely that "just" a gene causes panic attacks. What's more likely is that a gene causes someone to be more prone to other causes of panic attacks, such as hypersensitivity (more on that later). Nevertheless, there is reason to believe that genetics play a role in your likelihood of developing panic disorder.

Intelligence

With panic attacks, many experts believe that intelligence may play a role: research from 2012 shows a positive link between anxiety and higher intelligence. This doesn’t mean for sure that being intelligent causes you to be anxious, but panic attacks might happen more often in people  that "live inside their head". It's possible that those with a higher IQ have a tendency to focus more internally, increasing their awareness of their physical and emotional sensations and setting into motion panic disorder.

Hyper-sensitivity

Hyper-sensitivity is a greater overall awareness of your body. Everybody experiences aches, pains, and an increased heart rate every day. Those without panic disorder may not notice, and if they do, they rarely attribute it to something potentially dangerous. Those with panic disorder, however, are over-sensitive to these sensations. They not only notice every one - they also experience a surge of adrenaline and anxiety when they do. Some believe that panic attacks create hypersensitivity, while others theorize that hypersensitivity comes first. Ultimately, they seem to reinforce one another. 

Stress

Stress may also trigger panic attacks. In particular, those that are experiencing severe and chronic stress may be more prone to that first attack. It’s likely that this link exists due to the effect that stress has on our hormones, nervous system and thinking patterns. 

Misfiring Fight/Flight Response

Most anxiety experiences are linked to the fight or flight response. In addition, those with other forms of anxiety may also be more prone to panic attacks. It's possible that those with panic attacks have too much or too little of a neurotransmitter, or too easy a trigger for adrenaline, and this creates an internal environment in which one is more prone to panic.

Health Anxiety

Health anxiety can also be a factor in panic attacks. It's possible that health anxiety causes the first attack, because the first time anyone suffers from a panic attack they often worry that something is wrong with their health. It’s also possible, however, is that panic attacks themselves lead to health anxiety, and that health anxiety contributes to more panic attacks and panic disorder.

Health Issues

In some cases, panic attacks may be caused by medical conditions or drugs. It's not very common, but thyroid conditions that alter hormones, as well as some rare diseases like Lyme disease are known to increase your risk for panic attacks. Furthermore, there are some drugs that may cause panic attacks either while on the drug or during withdrawal.

Treating Panic Attacks

Panic attacks themselves can be managed or cured with the right anxiety reduction strategies - even if your panic disorder is genetic.In order to cure those panic attacks, however, it's important to look at the symptoms of panic attacks and how they affect you. Only then can you have a treatment designed to combat those symptoms.

Article Resources
  1. Anthony JC, Tien AY, Petronis KR. Epidemiologic evidence on cocaine use and panic attacks. Am J Epidemiol 1989;129:543-9.
  2. Coplan, Jeremy D., et al. The relationship between intelligence and anxiety: An association with subcortical white matter metabolism. Frontiers in Evolutionary Neuroscience 3 (2012): 8.
  3. Richard E. Carr, Panic disorder and asthma: Causes, effects and research implications, Journal of Psychosomatic Research, Volume 44, Issue 1, January 1998, Pages 43-52, ISSN 0022-3999, 10.1016/S0022-3999(97)00137-2.
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