The 4-Part Spiral That Creates Panic
Recently, we’ve been chatting a lot about anxiety.
I brought you 9 of my personal favorite ways to manage anxiety without medication and told you about 6 things that trigger anxiety.
Today, we’re chatting about the 4-part spiral that creates panic.
Panic attacks are super scary and bothersome, but knowing what creates them can help us stop the spiral and learn to master our panic.
The spiral is kickstarted with a trigger.
True panic attacks often seem to occur out of the blue, but they’re frequently actually triggered by some sort of unusual physical sensation.
Once the attack has been triggered, a four-part spiral creates panic.
PART 1 OF THE PANIC SPIRAL: BIOLOGICAL
First up: biological things happen.
This includes the obvious physical symptoms of panic, like racing or pounding heart, sweating, clammy hands, numbness and tingling, etc.
But it also includes things like differences in the way your brain is built or the way it works…some of those differences are things you inherit, while others have just developed over your lifetime.
Speaking of heritability, inheriting an anxious temperament or anxiety-related personality traits can contribute to panic.
There are also all sorts of brain systems that might be related to panic, ranging from neurotransmitter systems to hormone systems.
Plus, once a person has had a panic attack, the body seems to compensate by lowering the biological threshold for triggering another panic attack.
Then, it can actually trigger panic attacks without any sort of outside trigger…that’s where panic attacks start to happen out of the blue.
PART 2 OF THE PANIC SPIRAL: BEHAVIORAL
At the same time that all kinds of biological things are happening in a panic attack, there are behavioral things happening.
One is that our brains take an inventory of everything that was happening around us at the time of the first panic attack and flagging all of those little things as things that could potentially produce the same reaction in the future…I was wearing a yellow shirt when it happened, I just ate a taco, and I was at my grandma’s house, etc.
Your brain won’t know which of those things actually triggered the panic attack, so it’ll guess or just assume all of them might have been involved.
Then, in the future, your brain is extra cautious in similar situations and can be more susceptible to a panic attack.
Also, once you’ve had a panic attack, you never want to have another one.
So you might start avoiding situations involving yellow shirts, tacos, and your grandma’s house.
Unfortunately, if you do that, your brain never learns that your grandma’s house doesn’t actually have anything to do with panic, so you just remain afraid of her house.
Plus, we might escape new or similar situations if we start to feel “off.”
So I avoid going to grandma’s house because something about it just makes me afraid of having a panic attack…but now I’m at my aunt’s house and I’m kind of getting a funny feeling, so I better just go home so I don’t have a panic attack.
Seems reasonable, but escaping means your brain can’t learn that you’re actually safe, and it just becomes more and more sensitive to future panic attacks.
PART 3 OF THE PANIC SPIRAL: EMOTIONAL AND COGNITIVE
Once you’ve had a panic attack, your body pays extra attention to any sign you might have another attack.
So it becomes super sensitive to changes in your body — your heart flutters, you start breathing kinda funny, your toes get cold.
When you notice those changes, emotional responses will be triggered, often fear and anxiety.
Feelings often come with thoughts.
I’ve alluded to some of the cognitive things that happen once this spiral kicks off…you start thinking about everything you can do to avoid future panic attacks.
You start reasoning with yourself about why it’s best to give up yellow shirts and tacos.
You talk yourself into thinking you never really liked going to your grandma’s house anyway.
You notice those weird body sensations and have thoughts like
“Oh no! My feet are tingly! This is so weird. It’s never happened before. I better get to a doctor ASAP!”
“Ah! I totally messed up at that meeting. I need to go home now before people start asking me what went wrong!”
“Whoa! My heart feels weird. I might be having a heart attack!”
“If I go on this date, I’m definitely gonna have a panic attack!”
“No! I can’t have a panic attack now! I’ll look like a total idiot!”
PART 4 OF THE PANIC SPIRAL: SOCIAL
The final part of the 4-part spiral that creates panic is what it does to your life more broadly.
Panic attacks cause ripples at home, at work, and in relationships.
When you start to panic, your friends and family might rush over to console you or help you through it.
When your friends and family know you’re anxious about something or worried about having a panic attack, they might let you skip social events or change the event to something you think would be less likely to trigger a panic attack (sounds like a good thing but actually just keeps the panic alive in the future 👎🏻).
At work, panic can make it harder to concentrate or keep track of projects and deadlines, so you might end up working extra hours or doing work that doesn’t meet your own expectations.
Some people end up overcommitting to make up for the limitations they think their anxiety is causing, while others allow their coworkers to step in and take on bigger projects….which can limit their own opportunities for challenge and growth.
But even if you are offered a promotion or an exciting opportunity, your fear of how it will impact your panic symptoms could make you turn it down.
And a lot of people with panic find themselves isolating from the social aspects of work due to fear of having a panic attack in front of people.
They can really start missing out.
People with panic often spend a lot of time face-to-face with doctors getting weird, random symptoms evaluated.
This is part of the spiral that creates panic.
Often, doctors will provide a “no diagnosis” diagnosis and say there is nothing physically wrong causing the weird symptoms.
“But can they really be trusted?” your panic asks. “Did they really investigate everything? Maybe they missed something!”
These interactions with physicians and the thoughts and feelings they generate (part 3 of the panic spiral) feed into the overall 4-part spiral.
Need To See These 4 Components Interacting In a Diagram?
These four components of the spiral feed into each other and create a nasty dynamic that causes individual panic attacks and maintains fear of future panic attacks, which ultimately makes future panic attacks more likely.
In this article, I mentioned that a lot of our behavioral choices that make sense actually keep us stuck.
For panic, this is things like avoiding yellow shirts and not going to your grandma’s house.
In fact, for every mental health condition, we make certain choices that seem rational and helpful but are actually keeping the problem alive.
Next week, I’ll share with you 15 coping mechanisms that are keeping you stuck. Are you making any of these mistakes? Don’t miss it.
Talk to you soon,
Dr. Finch
P.S. Remember, this is education, not treatment. Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you. See the disclaimer for more details.
Hayden C. Finch, PhD, is a practicing psychologist in Des Moines, Iowa, dedicated to helping you master your mental health.
