What Exactly Is Happening to My Body during a Panic Attack

Panic attacks are very uncomfortable, but they are not dangerous. They are produced by a firing of your body’s “fight or flight” response system, also known as the sympathetic nervous system. This response is supposed to happen when you are confronted by a lion or a bear. In fact, if you were confronted by a lion or a bear, you wouldn’t even notice you were having a panic attack, because you’d be more concerned about escaping. But because your body is firing off this response when there is not a lion or a bear around, your mind jumps to the false conclusion that you must be dying or going crazy. (Most people don’t know about panic attacks, so it makes sense that they would initially make this mistake).nnDespite the intense discomfort, panic attacks are actually not harmful. In fact, during a panic attack you are at your peak ability to fight or run away. When you think about it, all of the panic attack symptoms make sense in this context. Your heart beats fast so you can pump more blood to your muscles and brain. You start breathing fast to you can get more oxygen to your muscles and brain. Your muscles tense up in preparation for you to use them. You start sweating to cool down your body. Your pupils dilate to get in more light, which can be perceived as spots in your vision. In addition, all of your non-essential organ systems power down so you can focus on running or fighting. In particular, your gastrointestinal system (throat, stomach, and intestines) powers down – which can lead to nausea, a choking sensation/lump in the throat (also known as globus), abdominal pains, constipation, and/or diarrhea. For a fair number of patients, these gastrointestinal symptoms, which are just side effects of powering down, are actually the main symptoms they experience during a panic attack.nnAll of this stuff is meant to get you ready to fight or run away. But if you don’t fight or run away, you will get even more symptoms which are still not harmful, but can be even more uncomfortable. For example, if you don’t use up your increased muscle tension, your body will start to shake. In addition, if you hyperventilate (breathe fast) for too long, without using up the extra oxygen, you will get rid of so much carbon dioxide that you will get tingling/numbness in the fingertips, a feeling of dizziness or lightheadedness, and the sensation of depersonalization (where your body feels like it’s not your own) or derealization (where the world seems like it’s not real). The hyperventilation is usually unnoticeable while you’re anxious because it can be quite subtle and takes a few minutes to build up. Of note, there is nothing actually dangerous about this hyperventilation or these symptoms. In fact, oyster hunters hyperventilate on purpose before they go underwater, because once they get the tingling/lightheaded symptoms, they can usually hold their breath for 2-5 minutes.nnOddly enough, when you measure the vital signs of a person who is actually having a panic attack, their heart rate and blood pressure do not change very much, despite the intense feelings. For example, their heart rate on average usually just rises by 5 beats per minute, and their blood pressure usually just rises 5 millimeters of mercury on average for both systolic and diastolic blood pressure. These are all relatively mild changes. So, your body is getting ready to fight or run away, and it feels like it’s fully active, but it’s actually not even nearly as active as if you fought or ran away for real.nnnn