Wednesday, June 7, 2023

Panic Attacks: What is Happening to Me?

If you’ve never experienced a panic attack, you should consider yourself to be very lucky. I have experienced many, and they can be brought on by all sorts of things, such as taking a math test or competing in a gymnastics meet. Regardless, they are scary to go through, and I want to explore deeper into what happens to your body when a panic attack is occurring. 

Visual of a Panic Attack


Panic attacks are not as uncommon as you may think, and there may be a time when you find yourself having one. Some clues that you might be having a panic attack are shortness of breath, light-headedness, nausea, shaking, tingling in the fingers and toes, and a sense of dread. These symptoms combined can often feel like something much worse, but it is just your body fooling your brain. What brings on a panic attack is usually an event or situation that makes you feel scared or panicked, which sets off an alarm in your brain and activates the body's fear response. More specifically, the amygdala in your brain (a pair of nerve bundles) sends a signal to the hypothalamus (a command center on top of the brainstem), which sends messages to the adrenal glands by way of the nervous system. Finally, these glands release adrenaline and cortisol (hormones) into the bloodstream which kick-start the body's fight or flight response.



Adrenaline (also known as epinephrine) is not just a hormone, but also a neurotransmitter. Once released into the bloodstream in reaction to stress, it kickstarts a series of pathways throughout the body. In order for the fight-or-flight system to operate, the body needs energy in the form of ATP, which is stored as excess glucose in the form of glycogen in the liver and muscle cells. Epinephrine acts as the ligand in a signal transduction pathway, and binds to a G-protein coupled receptor, in turn activating the G-protein. What is called a signal transduction cascade then occurs, producing cyclic AMP, the second messenger in the pathway. Cyclic AMP activates protein kinase A, which adds a phosphate group (phosphorylates) two enzymes: glycogen synthase and glycogen phosphorylase. This phosphorylation activates glycogen phosphorylase, which is responsible for breaking down glycogen, freeing glucose molecules for the body to use, as well as inactivating glycogen synthase, which builds glycogen, ensuring no new glycogen is being created. Now, the muscle cells can use the glucose produced by this pathway to respond to the event which released a surge of adrenaline.


Epinephrine Signal Transduction Pathway



Once the fight-or-flight response is activated, your heart rate will start to increase in order to take in extra oxygen, which can account for the shortness of breath and hyperventilation. Hyperventilation can cause us to take in more carbon dioxide, which brings on feelings of light-headedness/dizziness. Additionally, blood is diverted from regions of your body that are less essential, such as your fingers and toes, to the arms and legs, creating numbness/tingling in the areas with decreased blood flow. 




Symptoms of a Panic Attack


Although many people experience feelings of panic, a true panic attack must have symptoms that come on rapidly and all at once. This onslaught of symptoms makes your body think that you could be dying, or experiencing something much more serious, such as a heart attack. On the brighter side, panic attacks usually last no longer than 15-20 minutes, and there are ways to decrease this time frame even more. The first thing to do is to attempt to bring yourself back to reality, and assure yourself that you are not dying, and the feeling will pass eventually. This strategy includes the frontal cortex of your brain, which is responsible for problem solving and decision making. One of the most important techniques to ease a panic attack is to get control of your breathing, as hyperventilating will only prolong your symptoms. Even though it is difficult to change your breathing, it will significantly help to relax your body and mind. Focusing on longer exhales will activate the parasympathetic nervous system, which is a system your body uses to calm yourself during stressful situations. This system is the opposite of the sympathetic nervous system, which contributes to creating stress and panic. Deep breathing exercises will stimulate the vagus nerve, which carries messages to the brain, and controls many bodily functions, such as breathing rate and heart rate. Slow breathing sends a message to your brain through the vagus nerve that everything is okay, and there is no need for panic, which will eventually slow down your heart rate by activating the heart muscles. 


You may be wondering if there are other factors which may lead some people to experience panic attacks more frequently than others. In fact, there can be many underlying reasons for a panic attack to occur. For one, females are two times as likely to suffer from panic attacks than males are. Other risks for panic attacks can include having a family history of panic disorders, suffering from a mental illness, or experiencing traumatic events during childhood. Regardless of all of these, any number of things can trigger someone to have a panic attack, even if you’ve never had one before. 


What you should take away from this blog post is that panic attacks can be frightening, but it is important to know that your body is only trying to protect itself from a feeling of danger. They should never be associated with any embarrassment or shame, because they can happen to anyone. If you find yourself with the symptoms I described, know you will be okay, and what is happening to you is much more normal than you may think. Your body, which can cause such a terrible experience, knows just how to reverse it, if you allow it to. 



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