Many people visit the Emergency Room when they experience their first Panic Attack.
Many people that experience a Panic Attack for the first time visit the Emergency Room at the nearest hospital because they fear they are having a heart attack. The Emergency Room physician assesses them because misdiagnosing a heart attack could be catastrophic. Only after the necessary tests have been run and the physician has ruled out a heart attack is she able, with confidence, to tell you that you’ve had a Panic Attack.
The delay between arriving at the Emergency Room and being told you have had a Panic Attack can take several hours, at least in part because the physician is busy dealing with life-threatening events with other patients and has to find the time to come talk to you about your own condition.
You are not in danger of dying.
Given the intensity of the experience, and the fear that goes together with having an Attack, some people remain convinced there is something wrong with their heart even after a physician has ruled it out.
For many people, the fear of having another Attack can leave them overwhelmed even after they understand they are not in any danger of dying from the experience.
So, what could possibly be the value of a Panic Attack? Why do we have them? Why has evolution developed the ability in humans to get thrown so suddenly and intensely into such a dreadful state?
Panic Attacks make sense when viewed from an evolutionary perspective.
Panic attacks begin to make sense when you consider how your body physically responds when you are confronted with a real or perceived threat. Factoring evolution into it, too, can help you make sense of the experience.
We are not designed to live in cities, drive cars, work in office buildings, or sit at desks. Rather, your bodies evolved for you to live on the land, close to predators.
Consider what life would have been like 1000 or 10,000 years ago. We are designed to live in close proximity to predators, and to be under constant threat from them. Think about grizzly bears, cougars, and wolf packs to get the picture. You might think lions and tigers, depending on where in the world you live. Include aggressive human begins, too, when you consider predators that might want to hurt you.
Your primitive brain has perceived a threat. It believes death is imminent.
Now that you are thinking about living 1000s of years ago, with the constant potential danger of predators, consider what your respond would be if you were out picking blackberries in the wilderness and you heard a branch snap behind you. Picture yourself alone, just to make things a bit tenser.
Evolution has equipped you to deal with the threat. This makes sense, because otherwise the human species would have been wiped out long ago.
Your instinctive response when you heard the branch snap would have to be swift, right? You wouldn’t have time to consider the cause of the snap. Might it be your cousin coming to call you home at the end of the day? Or might it be a cougar?
If you stopped to consider all the possibilities, you would be dead. The cougar would have pounced on you from behind and broken your neck.
There is no time for thought in a situation like this. Instead, you must react instantly. It’s okay if you make a mistake and over-react. It’s under-reacting that will cost you your life.
So, what do you do? Immediately — bypassing your thinking brain — your primitive brain moves into action and floods your system with adrenaline. You know this response as an adrenaline rush.
Your body floods with adrenaline so you can either fight or run.
Adrenaline is a fast-acting hormone. It causes your heart to beat much faster so that it can supply your large muscles (think arms and legs) with oxygen and with fuel, which enables you to either fight the predator or to run from it. Maybe both.
Next, imagine what the adrenaline rush felt like the last time you were truly scared. Maybe after you spun out in on-coming traffic on black ice. Now compare that feeling to the symptoms of a Panic Attack, as listed below.
There are 13 symptoms listed in the DSM (Diagnostic and Statistical Manual, which is a diagnostic manual used by mental health professionals), but only six are listed below to help illustrate the point. To explore a complete list of symptoms, you can read the first blog post in this series of four posts about Panic Attacks, which describes how psychologists treat Panic Attacks.
The symptoms of a Panic Attack are the same as the symptoms of an adrenaline rush. Your heart pounds, you sweat, and you tremble.
As you read through the abbreviated list, imagine whether you would be feeling them if a cougar was stalking you.
- palpitations, pounding heart, or accelerated heart rate
- trembling or shaking
- sensations of shortness of breath or smothering
- feeling of choking
- chest pain or discomfort
During an adrenaline rush, your body moves you out of optimal arousal and into hyperarousal. You are familiar with hyperarousal – you know it as the fight or flight response — or as an adrenaline rush. Your heart pounds so hard that you can feel it in your chest. You sweat to cool your body during the anticipated exertion. And you tremble because high levels of adrenaline make your muscles twitch.
Panic Attacks exist so you can escape from perceived danger.
These physical reactions sound a lot like a panic attack, don’t they? The pounding heart? The sweating? The trembling? So, why do human beings have panic attacks? They exist to help you fight the predator that your body imagines it has just seen.
Panic Attacks are the outward signals that your body is prepared to either fight or run from imminent danger because your primitive brain – not your thinking brain – believes you will be dead in the next three minutes.
If there’s no danger present, then why do people have Panic Attacks?
Many people find it helpful to understand what has caused their body to believe that death is imminent in a Panic Attack because this understanding can help them to dismantle future Panic Attacks, and to frequently stop having them. In the next post in this series of four, you can read about What triggers a Panic Attack.
— Dr. Patricia Turner, Registered Psychologist, Calgary, Alberta