What triggers panic attacks?

Although many sufferers are embarrassed to admit to having panic attacks, it is actually a common problem and is believed to be on the rise. Accurate statistics are hard to come by, as not all people will seek medical help, but it estimated at least one in ten people will have a panic attack at some point in their life time. But why do people have panic attacks?

A panic attack is linked to the evolution of the 'fight or flight' response. When a person is in a threatening situation their body is primed to release a cocktail of hormones, most importantly adrenaline, which will help them defend themselves or flee the situation. But in a panic attack the body responds in this way in the absence of danger, leading to palpitations, chest pain, nausea and the many other unpleasant symptoms associated with the disorder.

Sometimes there is an obvious cause of the panic attack, but they can also happen out of the blue to a person who has no history of anxiety related disorders. The causes of panic attacks may be any of the following -

• Life events – A period of stress or an upsetting or traumatic event can trigger a panic attack, sometimes weeks after the event. Examples are the loss of a job or the death of a spouse.

• Phobias – If someone is phobic of an object or situation (for instance if they have a fear of crowded places) then this may trigger an attack. Once an attack has happened in a certain situation the sufferer can become conditioned to have further attacks under similar circumstances.

• Stimulants – too much caffeine can raise the heart rate and the risk of a panic attack. Nicotine can also be a trigger.

• Drugs – Marijuana and amphetamines are known causes.

• Medication – A small number of people have panic attacks as a side effect of taking certain medications such as Ritalin or the SSRI class of anti-depressants.

• Drug withdrawal – A person being weaned from a drug (either illegal or prescribed) is at risk of panic attacks. Alcohol withdrawal can have the same effect.

• Medical conditions and illness – Underlying medical conditions such as a thyroid problem are linked with an increased risk of panic attacks.

• Heart problems – tachycardia is a normal symptom of panic attacks, but there is evidence that individuals with underlying (and often difficult to diagnose) heart problems such as Wolff-Parkinson White syndrome may have a predisposition for having panic attacks.

• Hyperventilation – Bad breathing habits, for example breathing from the chest which leads to overbreathing, are thought to trigger panic attacks. Hyperventilation can cause dizziness and rapid heart rate, which are often the first symptoms a person notices during an attack.

• Hereditary predisposition – if there is a history of anxiety, panic attacks or depression in the family there is a greater likelihood of developing a panic disorder.

• Personality type – Introversion or a lack of assertiveness is linked to a much greater incidence of panic attacks.

A visit to your family doctor will, hopefully, help identify the cause of your panic attack. While panic attacks are a frightening experience it is unlikely that there is a serious underlying medical cause.