Panic attacks come on suddenly: sometimes in response to a clear trigger, sometimes after a build-up, and sometimes out of the blue. Even when you can’t identify a reason for the panic attack, there is usually a trigger that has set it off. This trigger can be internal or external. An example of an external trigger could be the last place you had a panic attack, which gets linked to the panic attack in your mind (and then seen as threatening)- so when you visit the same location, another panic attack is prompted. Triggers can also be internal, such as a thought, image, or memory, or a body sensation. People who experience panic attacks see body sensations (such as breathlessness, racing heart, racing thoughts, or dizziness) as bad or catastrophic. For example:
- racing thoughts = you are going crazy or losing control;
- dizziness = you will collapse or faint;
- breathlessness = you can’t breathe;
- racing heart or chest tightness = you’re having a heart attack.
The hard part is that when you interpret a range of body sensations as threatening, you become vigilant to them and tense. When you’re monitoring your body for signs of threat, you’re more likely to notice sensations or feelings that you wouldn’t otherwise. And when you’re tense, you’re more likely to have anxious symptoms such as breathlessness, heart palpitations, and dizziness.
It’s good to know that anxiety and panic often respond to psychological treatment. One small step you can take in the right direction is to consider how realistic your thoughts are. For example: have you ever actually collapsed during a panic attack, lost control, gone crazy, suffocated, or had a heart attack? If not, this is unlikely to happen- and therefore, not a real threat. Remind yourself that body changes are not evidence of imminent disaster.