There are two different types of panic attacks. One is when there is a real-life stressor, like if people you love are in danger. Your fight or flight response kicks in too intensely, leading to panic. Everyone is different: we each have varying thresholds of panic, and some might get triggered more easily than others.
Another type of panic, which is the type of panic people experience when they have Panic Disorder, is where people worry about having a panic attack, which actually causes the panic attack. Furthermore, they fear panic will bring some level of harm to them, such as a heart attack, stroke, the thought they are losing their mind, or simply embarrassment.
What those with Panic Disorder do not realize is that it is the fear of panic itself that causes panic. It becomes a cycle: "I'm scared I will panic, which makes me anxious." This causes the body to have physical anxiety symptoms (e.g., racing heart, labored breathing, feeling hot). The person thinks, "Oh no, am I starting to have a panic attack!" which makes them more anxious. Their body responds in kind, and the cycle spins out, causing a full-on panic attack. Simply put, the fear of panic triggers the panic attack. It is no wonder people feel like some panic attacks come "out of the blue," because this cycle can occur quickly and become uncontrollable in a matter of minutes.
People with Panic Disorder then incorrectly associate certain environments, activities, and triggers with their panic attacks. Therefore, when they confront these triggers, the fear of having a panic attack emerges, then leading to the panic. Sometimes, this fear of environments, activities, and situations triggering panic attacks becomes so strong, a person may fear leaving their own home, or if they do leave their home, they are unwilling to be in certain public places, such as on public transportation, in open/enclosed spaces, or in large crowds. This condition, known as agoraphobia, develops because a person believes they will not be able to safely attend to a potential panic attack in their environment. Agoraphobia can develop for other reasons as well, besides the fear of panic. Sometimes it develops because people may just fear something dangerous happening to them in the world.
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Cognitive Behavioral Therapy and Assessment Associates
