Causes of panic

Panic has multiple causes.   It's a fairly complex story.  But since you wondered "Why me?", you deserve the best summary of research and information about the causes of panic. Let's start at the day of your birth and take it to the present and see how factors contribute along the way:

Genetic Causes

An inherited predisposition to panic probably does exist, even though the hard evidence for it not there.  Some have supposed an "general excitability" factor may be inherited and predispose one to panic later in life, given the right conditions. Some evidence shows that 40% of phobics, for example, have close relatives who are phobic, too. Still, 60% are not phobic. The best evidence for a genetic marker is that of identical twins reared separately, who later become phobic at the came time in life.  This research is very difficult and has not been done.  The problem in such research is that those who are raised with other phobics in the same family can learn from modeling or emotional contagion to be prone to panic,  not just from a genetic factor.

Childhood Causes

Early influences, such as family instability, early separation, and trauma and abuse,  show up in about 30-40% of adults who panic. Childhood causes seem to influence some, but not all, to experience panic later in life. However, these rates ae not much different from the percent of adults you would expect who have had trauma, etc. in childhood.  Many who have had a stable childhood also have panicked later in life. It seems likely, then, that everyone has the capacity for panic and that it can appear with the right circumstances.  In support of this is the astonishing finding (two studies) that about 32% of all adults panic at least once in any given year. 

Personality Causes

The personality type most likely to panic is a worried and guilt-prone person whose alarming thoughts alone can bring on panic.  A  person who is perfectionistic in character, i.e. very conscientious and controlling, can also be more prone to panic, especially in social situations, such as in public speaking and meeting people. Unusually shy or avoident persons are more likely to panic as well.  All of these personality traits or type seem to contribute to making panic worse or unusually persistent.   They are not a direct cause and are certainly not found in everyone who panics.

Precipitating  Causes

Stressful life events that make one feel insecure and helpless appear often in the few months before the very first panic attack, as well as just before a renewal of a round of attacks.  For example, a death in the family, a job change, a divorce, or a major move are fairly common.  Sometimes these stressful events happen together naturally, as in marrying, getting a new job, having a child on the way and many new responsibilities.  The average age of onset of the first panic attack is consistent with these events : about 23 years for agoraphobia, about 16 years for social phobia and about 16 years for obsessive-compulsive. 

Immediate Causes

The cause that is probably always present in some form is being trapped in a situation you believe you can't escape from and often can't get help for. The traps can take the physical form of being in a confined, dark, unfamiliar place.   I can also take the form of social traps:  judgments, criticism, and public exposure.  Many attacks that appear to have no cause, i.e. "out of the blue", later reveal their specific origin to a careful observor.  The most typical traps are: driving, crowds, buses, trains, elevators, airplanes, churches, movies, malls, stores, public talks, meeting people, parties, restaurants, dental chairs, waiting rooms, hospitals, and being alone. 

Physical Causes

This cause is present all the  time.  It consists of a casade of stimulants and hormones that are released into your bloodstream and course through your whole body once the alarm of being trapped has started.  These changes in sensations and feelings are real, not imaginary, consequences of these stimulants.  The stimulants include adrenaline, epinephrine, glycogen, cortisol and up to 20 known substances.  Adrenaline, for example, causes palpitations and heart racing, tingling and numbness in the limbs, and sweatiness. Most of these stimulants are metabolized away by the body in four or five minutes or so, unless one adds more alarming thoughts.

Sustaining Causes

Sustaining causes are those that keep panic going once it starts.  The two major sustaining causes are widely recognized: excessive worry and avoidance.   Excessive worrying is imagining the worst things that could happen if one returned to the panic situations, e.g. being stuck, embarassed, faint, nauseous, etc. This is also called the "what-if's", anticipatory anxiety, or the second fear.   Worry keeps a cycle ( worry - anxiety - body symptoms - more worry)  going on and worsening.  Avoiding the panic situation also keeps anxiety high and makes one more sensitive to the panic situation.  The more one avoids, the more fearful one gets.   Modern therapies target these "sustaining" causes.

How can you put an end to this?

Effective treatment, whether self-help or through the help of a qualified professional, can put an end to your panic.

How do you find effective help?  See Treatments for details in finding the most effective help for your panic, as well as specific questions to ask when seeking a qualified professional.  If you would like information about Dr. Raynard - The Panic Doctor - visit the Credentials page.  

To be panic free is a reasonable hope,

no matter how long or severe your attacks have been.