How do panic attacks work? Like hormones?



How do panic attacks work? Like hormones?

In: Biology

Your body releaes adrenaline which amps you up as if your life was on the line. Adrenaline is what creates the flight or fight response which increases your heart rate and shuts down your digestive system. But the problem is that our bodies give that response in scenarios that aren’t life threatening therefore we just call it a panic attack.

This is how my therapists have explained it over the years, plus my own research as a psychology student (I have panic disorder, social phobia and general anxiety). The basic idea of the fight/flight response is one factor, though in a panic attack you generally can’t pinpoint the event that triggered the response. You can then start to develop anxiety or fear related to the *idea* that you’re going to have a panic attack, which can then make panic attacks more likely. It was explained that the panic attacks get put in the same category as a tiger in your mind. Sometimes you can stop this or recategorize the panic attacks as less dangerous than a tiger, but the human mind is a strange and complicated thing, so this doesn’t always work (speaking from personal experience). They’re also hard to study. One of the favorite ways to study mental health issues is to put people in an fMRI to see what their brain is doing. But to do this you have to either get someone into the machine as soon as they start to panic (super impractical if they have their attack away from the hospital/clinic) or induce a panic attack in someone (which is both a flawed research design since the attacks aren’t “natural” as well as super ethically dodgy).

As far as alpha and beta blockers go, I’m more familiar with beta blockers since I’ve been taking one for about 5 years for both my anxiety and my hypertension. I also take an alpha blocker, but it’s newer and I haven’t done as much research into it. They do help with some of the symptoms of a panic attack (I don’t feel like my heart is going to explode) but there are symptoms that they don’t touch (trouble breathing, tense and shaking muscles, “spiraling” or racing thoughts, etc.), and they have side effects at higher doses. My alpha blocker, for example, makes me super drowsy so I take it right before bed. I’ve about maxed out the safe dose for my beta blockers, according to the docs. Beta blockers also take awhile to have full effects, up to an hour or two. Panic attacks are rarely that long when left alone or handled with other techniques (deep breathing, reminding yourself you’re not going to die, someone else helping to coach you down, etc.), so using them in the moment isn’t as helpful as taking them regularly or before you do something that might trigger a panic attack. Taking too much of either can drop your blood pressure too low and you can pass out. Though, I guess you wouldn’t be panicking anymore lol.

So, the TL;DR boils down to 3 things: 1. Panic attacks aren’t only the fight/flight response, but brains are super complicated and weird so we aren’t sure of all the factors or even really how to study them. 2. Most medications take longer to act than a panic attack lasts as well as only targeting some of the symptoms. 3. There are side effects to alpha and beta blockers at higher doses that some people would need to take, like fatigue/drowsiness, low blood pressure, or are addictive (like benzos), that aren’t always worth the trade off.