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Panic! Panic! Panic!

  • Panic attack: When you are so overcome by anxiety that you feel physically in danger even though there is no real threat.
  • Did you know that NHS statistics show panic attacks affect one in ten people? 

There are various theories about what triggers a panic attack. The ‘learning theory’ suggests that when you encounter a situation previously experienced in a panic attack, you are more likely to experience another panic attack. In the ‘cognitive theory’, panic attacks are initiated by misinterpreting normal bodily actions as anxiety, so your brain overestimates the possibility of danger. Lastly, the ‘psychodynamic theory’ predicts that trauma can induce a self-protection mechanism of the brain, preventing you from remembering the event that initially caused the panic attack.

The question is, what are the underlying causes of panic attacks? Psychologists and scientists suggest that they are probably due to a combination of psychological factors and genetics.

A person’s psychological state is thought to play a role because people who are unhappy or undergoing significant life changes, such as a divorce, experience high levels of stress and are more likely to develop panic disorders. This makes sense because if you have more issues to worry about, you’re more worried to begin with, right? Psychologists also suggest that your upbringing may have a strong influence on your likelihood of developing panic attacks, especially if your parents suffered from them as well. This is because they are more likely to have been overcautious with you, causing you to be more anxious than other children.

Your lifestyle choices can also play a role. Ever had too much coffee and noticed that you’re shaking? Coffee contains caffeine, a stimulant; nicotine is another well-known stimulant. The problem with stimulants is that they get your heart racing, muscles firing (making you shake) and can make you feel sick… sound similar to a panic attack? It makes senses then, that people who take a lot of stimulants are more likely to have panic attacks.

But we all suffer from psychological stresses at times, so why doesn’t every-one suffer from panic attacks? The answer may lie in our particular genome. Recent scientific studies have discovered 17 different ‘panic’-related genes, in which mutations of a gene (alleles), can influence anxiety levels and might predispose you to panic attacks. These genes were identified by comparing the genomes of a healthy control group and a group of panic sufferers to see whether the alleles differed between groups. Most of the genes identified appear to affect neurotransmitters, chemicals produced by the brain that can activate or deactivate different parts in your brain. So if a neurotransmitter activates a certain part of your emotional centre, for example, you would feel happy. Mutations in neurotransmitter-encoding genes can affect the production, release or re-uptake of neurotransmitters like serotonin.

If you have ‘normal’ serotonin levels, you probably feel generally happy. If you have high or low levels of serotonin, however, you may experience more negative emotions, making you more likely to experience panic attacks. Similarly, interference with other neurotransmitter pathways, such as those which modulate adrenaline, a stress hormone that affects the heart rate, is also linked to panic attacks.

Methods to cure anxiety disorders include psychological therapy; either traditional ‘talking’ counselling or cognitive behavioural therapy, which combines counselling with behavioural exercises to help sufferers deal with their anxiety. Drugs can also be used to treat anxiety disorders, helping you feel more relaxed, but they can have side effects and are best used in conjunction with psychological therapy. These methods are by no means cures, however, and each treatment varies in its success rate.

While psychologists and scientists now know much more about the causes and treatment of panic attacks, research in the future needs to focus on how the different ‘panic’ alleles affect the pathways. Hopefully this will allow the development of drug treatments that can be better targeted for each individual.

Emma Butcher is an undergraduate in the Department of Medicine

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