Panic Attacks (Part 2): Causes

While it may feel as though a panic attack comes out of the blue, there is always a trigger.  These triggers can be internal (physical sensations or thoughts) or external (an actual or perceived threat in your environment).  Examples of external triggers include: an argument, a loud noise, hearing bad news, or exposure to a phobic situation.  Internal triggers are thoughts (i.e., worry), physical sensations, and emotions. Panic attacks always include physical changes in your body, and typically there are several. There is always fear (panic) that causes additional physical sensations like tachycardia (rapid heart rate).

Prior to the fear, the physical sensations can be caused by a variety of factors including dehydration, low blood sugar, side-effects to a medication, hormonal changes, caffeine, and even artificial lighting (especially fluorescent lights) and lack of sleep. This time of year heat exposure commonly contributes to panic attacks by causing a variety of symptoms such as weakness, lightheadedness, and nausea.  Heat exhaustion, dehydration, and low blood sugar each contain enough of the same symptoms of a panic attack to qualify as one.

Most of the time someone’s first panic attack is a perfect storm of  “normal” symptoms (e.g. tachycardia, nausea, and lightheadedness are normal when dehydrated) that scare them so much that they panic, causing a spiral of additional symptoms.  I’ve seen countless people who are very relieved when I provide a physical explanation for their first episode, because they are often convinced they have a serious illness. For HIPAA reasons I can’t use a detailed actual example but typically there are at least three factors, and sometimes multiple symptoms, contributing to the first panic attack - like sleep deprivation, dehydration, low blood sugar, preceded by exposure to fluorescent lights (can bring on derealization) setting them over the edge. Psychological stressors often contribute to the first panic attack and some people are genetically prone  to anxiety.

Check in soon for what leads to panic disorder as well as the amazing treatment for panic attack.

-photo by Timothy Dykes on Upsplash