What Causes Panic Attacks and How Do We Treat Them?

Earlier this week, I released a video on this same subject, so if you’re interested, this article can also be viewed below.

If you’re reading this article, you’re probably familiar with what a panic attack is: a sudden explosion of adrenaline within our body that usually lasts half an hour to an hour, but can go on for much, much longer. 

If we google “what causes panic attacks,” we’re assaulted with a whole bunch of answers. Most sites attribute it to a combination between brain chemicals and family history, but that leaves us with more questions than answers. How does something we experienced so far in the past lead us to have these adrenaline spikes in the present? If our serotonin levels are lower than everyone else’s, why does panic only last for short bursts, after which our brain goes right back to normal?

As it turns out, the cause behind panic attacks is neither nature nor nurture, and that the true biological mechanism is something entirely different. If we look at how our brain produces adrenaline, we can see that there are two paths it can follow. First, our brain produces small amounts of adrenaline on its own throughout our day. We can’t control or affect this mechanism, but the amount of adrenaline produced is so small that practically, it doesn’t really matter. Second, however, certain behaviors we engage in can directly cause our body to make adrenaline. One such behavior is worrying - imagining past, present, or future discomfort.

When we worry, it signals to the rest of the brain that it’s in danger, causing it to create adrenaline at a much higher volume than the brain does on its own.

This adrenaline causes some uncomfortable symptoms like some mild nausea or a slight increase in heart rate (1). If we notice this (2) and choose to worry about it (3), it makes even more adrenaline, causing those symptoms to get stronger (4). 

If we notice and choose to keep worrying about it, our body will keep producing adrenaline until we experience the strongest symptoms our body can muster - dry heaving, intense dizziness, a heart rate over 150 BPM, and intrusive thoughts coming at a mile a minute - all of which last until we stop worrying.

These experiences can be absolutely debilitating. However, when we understand the science behind them, the solution becomes clear: cut off our worrying. If we can experience these symptoms without worrying about them, our body won’t create giant amounts of adrenaline and we will no longer experience panic attacks.

This is the difference-maker in treatment, the specific change that allows some people to completely recover from panic attacks rather than having to cope with them indefinitely.

This might sound simple at first glance, but for those of us who experience regular panic attacks, not worrying about them can feel impossible. We encounter questions like:

Last time I had a panic attack, I got so nauseated, I almost threw up. How can I not worry about that?

Every time I have a panic attack, I get hit with thousands of thoughts a second, making me feel like I’m going crazy. And I’m supposed to not worry about that?

Don’t panic attacks sometimes cause things like heart attacks (for the record, they do not)? What if I don’t worry about it and have a heart attack?

These questions can be really difficult to answer without an understanding of what happens during the anxiety process, and the reasons we feel certain symptoms during a panic attack.

This is why I wrote a whole book on the subject, one that explains everything you’ve ever wanted to know about how anxiety works and what we can do about it. It comes out January 5th, but you can pre-order your copy today.

(All images in this article are copyrighted. Please contact Jotham Sadan for permission to reuse)