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What are the causes of panic attacks and panic disorders?

Suddenly, out of the blue you break into sweats, palpitations, tremors all over your body and shortness of breath. The list of symptoms of a panic attack is often long, including chest pain, nausea, dizziness, and drowsiness.

Many people who have experienced a panic attack or suffer from panic disorder still remember their first panic attack well after some time. Often, however, it is unclear to them why this came about in the first place, i.e. what specific causes could have triggered the panic attack.

What is a panic attack anyway, where does it come from and how does it arise? You will find answers to these questions as well as helpful tips on what to do in an acute case in this article.

What is a Panic Attack?

A Panic attack is a short phase of extreme anxiety that sets in suddenly and is accompanied by physical symptoms such as palpitations, dizziness or shortness of breath. Read our article "Getting Rid of Panic Attacks" to learn more about how a panic attack typically manifests itself.

Panic disorder are recurring panic attacks that usually lead to an excessive fear of future attacks (fear of expectation). This often goes hand in hand with changes in behavior and so-called avoidance tactics on the part of those affected.

Possible causes of panic attacks

The main symptoms of a panic attack are often of a physical nature - those affected often seek help and advice from a cardiologist instead of a psychotherapist or psychiatrist. A physical evaluation is important, but should not rule out psychotherapeutic treatment in an emergency.

What causes a panic attack in individual cases is usually very individual. However, there are some general risk factors that can make panic attacks more likely:

  • (Chronic) Increased stress
  • Existing mental illnesses such as depression, obsessive-compulsive disorder, or post-traumatic stress disorder (PTSD)
  • Fears and phobias (e.g. agoraphobia, claustrophobia, or fear of spiders)
  • Stressful life events
  • Anxious personality traits

Biological causes can also play a role in panic attacks. For example, it is possible that the balance between messenger substances such as serotonin and norepinephrine in the brain is disturbed. This imbalance can lead to overexcitability of the nervous system and thus to panic attacks.

Panic Attack Triggers

Although the factors mentioned can form the basic causes for the development of a panic attack, they are not enough on their own to actually trigger a panic attack. As with many other mental disorders, the development and maintenance are multifactorial.

The consumption of alcohol, nicotine or caffeine can be counted as specific triggering conditions. Here is a specific example: The consumption of caffeine can lead to certain body reactions such as an increased heartbeat. If this body reaction is assessed as threatening (e.g. in the form of catastrophic thoughts such as "I'm going to have a heart attack"), this can lead to a panic attack. Some drugs can also promote the occurrence if they trigger certain body reactions and these are rated as threatening.

Maintaining Panic Attacks

Over time, many sufferers develop various avoidance tactics that can help keep panic attacks going. For example, places, situations or activities classified as supposedly risky are avoided or no longer visited alone, but only with someone else.

For example, traveling by train is avoided completely for fear of a possible panic attack. As a result, it cannot come to the experience that the fear-trigger “traveling by train” is basically not dangerous and that the person concerned is able to withstand their fear. Avoidance then leads to the opposite effect: The fear trigger becomes increasingly important and becomes stronger. As a result, there can be a real fear of fear. This is also known as "anticipatory anxiety".

Unconscious causes: panic attack for no reason?

For most people, the first panic attacks appear surprisingly and very suddenly. The causes of panic attacks and panic disorders already mentioned can also play an important role here. However, very few of those affected are able to consciously identify the causes.

But even if we have the feeling that the panic attack appears out of the blue, there is a trigger. Often these are body reactions that are assessed as excessively threatening or strong feelings such as anger or joy that lead to (over- and misinterpreted) body reactions. But also fear-inducing thoughts. However, in many cases the connection between these triggers and the panic attack is not consciously made. This can make it feel like panic attacks happen for no reason at all and out of the blue.

Anxiety Management Strategies

Panic attacks can be very distressing and they can affect people anywhere in the world. But there is also good news: there are many helpful methods and ways to treat them.

Even if panic attacks can appear suddenly and for no reason, you are not helpless at the mercy of them. We introduce you to a number of methods for coping with anxiety that can be very helpful and that you can implement on your own.

Deal with your personal signs of fear and make yourself aware of them. When the next panic attack comes along, remember that you can influence how it develops. Try to be as calm as possible and pay attention to how you evaluate the situation. You may quickly notice that it is not the body reaction or situation itself that triggers your fear, but that your assessment plays a major role.

So assuming a certain body reaction, such as a fast heartbeat, tremor, or tightness in the chest, is a disaster, will make your anxiety worse. Instead, try to make it clear to yourself that the symptoms of the panic attack are unpleasant, but you can endure them and, above all, they will soon pass and in no way endanger your life.

In fearful situations, and especially during a panic attack, the breath becomes very shallow and fast. Breathing exercises can be very helpful if you are already in the middle of a panic attack. But they also offer a good opportunity to do something about fear in advance.

Stand up straight, adopt a relaxed posture, and let your shoulders relax. Inhale deeply and calmly through your nose. You can slowly count to 5 in your mind as you inhale. Then breathe out loosely through your mouth and slowly count to 7 in your mind. If you want, you can place a hand on your abdominal wall to feel it slowly rise and fall again. Repeat this exercise 10 times in a row and do 4 repetitions. You can do the exercise in the morning right after you get up, at noon if you take a few minutes or even in the evening before going to bed.

In this way you can support yourself and your body in getting back to a state of rest more quickly. Regular breathing exercises are worthwhile: the more frequently breathing exercises are used, the better they work.

3 Avoid stress as a cause of panic attacks

A low stress level helps to take action against panic attacks and their causes in advance. Because a permanently increased stress level can have many negative effects on our physical and mental health.

The occasional short, stressful phase in life can often not be avoided entirely. However, these phases should be exceptional and not become permanent. In addition, it is very important that you take time to rest and breathe in the hectic pace of everyday life. It is best to ask yourself the question several times a day: “What do I need right now and what can I do for myself?” This way you can always keep an eye on your stress level and take action at an early stage.

Getting enough sleep and reducing your consumption of caffeine, nicotine, and alcohol can also help. And sport can also have a stress-reducing and therefore health-promoting effect.


Tips for emergencies

  • Put your focus on your breathing: It is important to exhale longer than inhale. The best way to do this is to count up to six internally when exhaling and to four when breathing in, followed by a short break. Repeat this sequence several times until your breathing returns to normal.
  • Hop up and down and clench your fists: If you notice that your throat feels constricted and you suspect a panic attack is on the way, hop up and down a few times. This way you can relax the cramped muscles quickly and you can also do yours Hands closedClench fists and solve again. This additionally strengthens the relaxation process.
  • Claw your toes in the ground: In addition, you can press your feet into the ground and repeatedly claw your toes into the ground. This also has a relaxing effect on your body.
  • Think of oneloved ones: Thinking of a loved one and loved one often helps with the first hint of an attack, facial features relax, and we distract ourselves.

to accept help

There are a variety of helpful exercises and methods that you can do well on your own. However, it may still be advisable to seek medical or psychotherapeutic help as well. With support, it can sometimes be easier to confront and cope with fear. The exchange in self-help groups also offers good support for many affected people in order to get to the bottom of the causes of panic attacks and panic disorders.

At HelloBetter, we have developed online training against panic that supports you in dealing with fear and panic in more depth. The effectiveness of the training has been proven in a clinical study. Have a look!

Categories Anxiety & PanicTags panic, panic attack, panic disorder, exercise