Panic Disorder Causes & Risk Factors
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Panic disorder has both biological and psychological causes. Because the disorder runs in families, researchers are examining several genes that might contribute to its development.
Some experiments suggest that panic disorder is the result of a hypersensitivity to brain changes that transmit warning messages. In these experiments, panic attacks were induced in susceptible people with high doses of a stimulant like caffeine, which activates the sympathetic nervous system (a part of the autonomic nervous system). The sympathetic nervous system transmits signals to all parts of the body to prepare it for physical action, known as the "fight-or-flight" response. It speeds heart rate, narrows blood vessels, and raises blood pressure.
In most people, large amounts of caffeine produce some of the physical symptoms of panic, such as increased heart rate. But among individuals with panic disorder, too much caffeine can trigger a full-blown panic attack. In similar experiments, deep breathing caused by strenuous exercise or inhaling air with a high concentration of carbon dioxide provoked attacks in people with panic disorder. The brain seemingly misinterprets deep, rapid breathing as a sign that the body is in trouble and triggers a stress response.
One theory is that faulty brain receptors don't respond to naturally occurring benzodiazepines, the body's anxiety-reducing chemicals. Some research suggests that panic disorder may involve an abnormality in the limbic system. Brain images of people having a panic attack show abnormal activity around the hippocampus, a key component of the limbic system.
Psychological factors are also important because a major symptom is the fear of having more panic attacks. People become conditioned to anticipate the attacks. This anticipation produces anxious thoughts, which may induce panic attacks. Researchers think the amygdala may play a role in anticipatory anxiety and are studying this part of the brain, where fear conditioning and other forms of unconscious emotional learning occur.
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People panic for all kinds of reasons: driving in snow, taking a test, leaving a purse on the subway. One of the big causes of panic attacks is, rightly, having trouble breathing—and that triggers a vicious cycle in which anxiety aggravates breathlessness and breathlessness in turn creates further anxiety. Some patients experience such a severe case that they're convinced they're about to die. The strategy for these people is to slow down and regain control: Stop, purse your lips, and drop your shoulders.
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Panic disorder sometimes runs in families, but no one knows for sure why some people have it while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
This answer is based on source information from the National Institute of Mental Health.
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Panic disorder typically first occurs in late adolescence or early adulthood, but may also begin in childhood. Women are twice as likely than men to experience this disorder, and some people may be genetically predisposed to the disorder. About 1 to 2 percent of Americans suffer from panic disorder.
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Although panic attacks and hyperventilation both have physical processes that are also associated with them (i.e., thyroid disorders, magnesium and vitamin deficiencies, etc.) I have found that the most common psychological component is the burying of feelings. Most people find that these attacks occur not during periods of stress, but when they finally have a chance to relax, such as when they are driving a car or watching television. This is because hyperventilation and panic attacks are often caused by suppressed feelings. The attacks occur when these feelings finally bubble up to surface while being split off from the triggering event. In susceptible people, this then triggers the attacks.
Although one can break the biochemical part of the attack by breathing in and out of a bag (this raises carbon dioxide levels in the blood, which can end the attack) or doing abdominal breathing where the abdomen expands outward during inhalation allowing the person to take a bigger breath, the most important long-term solution is to simply feel what one is feeling without resistance.
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A panic attack is a sudden wave of intense anxiety, apprehension, fearfulness, or terror, with physical symptoms such as shortness of breath, palpitations, sweating, and chest pains. Attacks may occur under stress or for no apparent reason (spontaneous panic attacks).
The underlying biological cause of panic attacks is not known. However, researchers theorize that it involves abnormalities in the areas of the brain responsible for interpreting potential threats, such as the amygdala (the brain's "fear center"), locus ceruleus (area of the brainstem that helps determine which stimuli are worth paying attention to), and hippocampus (plays a central role in processing long-term memories). Imbalances of the neurotransmitters norepinephrine and serotonin may also play a role.
People with a current or past anxiety or mood disorder are at greater risk for panic attacks. Use of stimulants, such as methylphenidate (Ritalin), caffeine, or cocaine, can also promote panic attacks.