When Panic Attacks

Bring Out the Dread continued...

Given that, my own freak-out wasn't as random as it seemed. The seeds of my attack had been planted six months earlier, when I moved to Spain to study abroad, then later returned to the States only to transfer to a new university. Add an on-again, off-again relationship to the mix and I was a panic attack waiting to happen.

But everyone gets stressed and experiences loss. Why do some of us end up hyperventilating into a paper bag while others can decompress with a few Mike's Hard Lemonades and a round of PlayStation 3? Experts still don't know exactly why or how stress sets off an attack, but some believe it's a result of faulty neural wiring. "One theory is that in some people the brain circuitry responsible for processing emotion and fear is in a state of hyperexcitability," Wilson says. "This may cause the brain to mislabel nonthreatening, everyday stress as highly dangerous and set off a false alarm that sends your body into Defcon 1 status." Sometimes this irrational response is genetic. Call it an inherited proclivity toward panicking.

Brain scans show that many of the same stress hormones that are activated during the body's instinctive fight-or-flight response are triggered during a panic attack. Two possible culprits: adrenaline and noradrenaline. "Evolutionarily speaking, these hormones would be released when you're faced with a lion or a bear," says Lindsay Kiriakos, M.D., a clinical instructor in psychiatry at the UCLA Neuropsychiatric Institute and the author of Panic Disorder: How to Fight Back and Win. Both hormones shift your respiratory and circulatory systems into overdrive to prepare you for action. With massive amounts of oxygen pumping into your muscles and brain, you can react quickly to a killer grizzly. "The problem is that, during a panic attack, this extreme response occurs without the presence of any real outside threat," Kiriakos says. Without a real enemy to respond to, whether it's the snarling beast our ancestors had to contend with or a modern-day carjacker, the rapid breathing and muscle tension that would otherwise help us can translate into hyperventilation and trembling. "Sufferers can't figure out what's happening to them, and the confusion can be terrifying," Kiriakos says.

Some scientists theorize that noradrenaline may be to blame for much of that confusion. When this hormone hits the frontal lobe, which is associated with judgment and reasoning, among other things, your ability to think clearly may get jammed up. Unable to comprehend the ensuing cyclone of negative sensations, people assume the worst: that they're dying or having a heart attack. In fact, according to a 2003 study in the Canadian Journal of Emergency Medicine, people with Panic Disorder are significantly more likely than people without the disorder to head for the ER due to chest pain.

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