By Paula

IN A SPONTANEOUS panic attack, your body goes through exactly
the same physiological flight reaction that it does in a truly
life-threatening situation. The panic attack that wakes you
up at night or occurs out of the blue is physiologically
indistinguishable from your response to such experiences
as your car stalling on the railroad tracks or waking to hear
a robber going through your house.

What makes a panic attack unique and difficult to cope with is
that these intense bodily reactions occur in the absence of
any immediate or apparent danger. Or, in the case of agoraphobia,
they occur in response to situations that have no apparent
life-threatening potential (such as standing in line at the
grocery store or being at home alone). In either case,
you don't know why the reaction is happening. And not knowing
why--not being able to make any sense out of the fact that
your body is going through such an intense response--only serves
to make the entire experience even more frightening. Your
tendency is to react to sensations that are intense and
inexplicable with even more fear and a heightened sense
of danger.

No one fully knows at this time why spontaneous panic attacks
occur--why the body's natural flight mechanism can come into
play for no obvious reason or out of context. Some people
believe that there is always some stimulus for a panic attack,
even if this is not apparent. Others believe that sudden
attacks arise from a temporary physiological imbalance.
It is known that there is a greater tendency for panic attacks
to occur when a person has been undergoing prolonged stress
or has recently suffered a significant loss. However, only
some people who have undergone stress or loss develop panic
attacks, while others might develop headaches, ulcers, or
reactive depression. It is also known that a disturbance
in the part of the brain called the locus ceruleusis implicated
in panic attacks; but it seems that this disturbance is only
one event in a long chain of causes without being the primary cause.

Because there is no immediate or apparent external danger
in a panic attack, you may tend to invent or attribute
danger to the intense bodily sensations you're going through.
In the absence of any real life-threatening situation, your
mind may misinterpret what's going on inside as being life-
threatening. Your mind can very quickly go through the following
process: "If I feel this bad, I must be in some danger.
If there is no apparent external danger, the danger must be
inside of me." And so it's very common when undergoing
panic to invent any (or all) of the following "dangers:"

In response to heart palpitations: "I'm going to have a
heart attack" or "I'm going to die."

In response to choking sensations: "I'm going to stop breathing
and suffocate."

In response to dizzy sensations: "I'm going to pass out."

In response to sensations of disorientation or feeling
"not all there": "I'm going crazy."

In response to "rubbery legs": "I won't be able to walk"
or "I'm going to fall."

In response to the overall intensity of your body's reactions:
"I'm going to lose complete control over myself."

As soon as you tell yourself that you're feeling any of
the above dangers, you multiple the intensity of your fear.
This intense fear makes your bodily reactions even worse,
which in turn creates still more fear, and you get caught
in an upward spiral of mounting panic.

The upward spiral can be avoided if you understand that
what your body is going through is not dangerous. All of the
above dangers are illusory, a product of your imagination
when you're undergoing the intense reactions which constitute panic.

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