What is a panic attack?

A panic attack occurs when the body releases adrenaline and no physical action is taken in response to it, which is what we are biologically wired to do. This confuses the body, and it begins to look inward for danger.

All anxiety diagnoses are the result of this lack of action. Without it, there would be no anxiety diagnoses.

There are several reasons why we do not act on it:
• When there is no external danger to respond to.
• When we feel it is not physically possible to act, for example in an elevator or a car.
• When it is not socially acceptable, such as standing in a checkout line, sitting in a meeting, on a bus or train, or giving a presentation in class.
• When we are physically restrained, for example at the dentist or hairdresser, where we are fixed in a chair.
• In other situations, such as at home on the sofa, when it comes so suddenly that it completely surprises us and we do not have time to react, but instead become startled.

Do you recognize the pattern? These are exactly the kinds of places where anxiety is experienced the first time, precisely because no physical action is taken in response to the adrenaline.

The reality is that if you acted in those situations, you would not experience an anxiety or panic attack.

Imagine jumping in place in an elevator to burn off the initial adrenaline symptoms. No panic would occur because the brain registers that you are moving, there is no danger, and normal adrenaline discharge is taking place.

Now imagine doing the same for 30 seconds in a checkout line, in a car, on a bus or train, at the dentist, at the hairdresser, in a meeting, during a presentation, at home on the sofa, or wherever you first noticed the symptoms. No panic would occur.

Panic does not arise when adrenaline is discharged through physical action. That is what happens in rational fear caused by a real threat. Adrenaline is released and burned off within seconds.

In irrational anxiety, adrenaline is released and circulates in the body without being discharged. Natural metabolism, without physical action, takes five to ten minutes. That is typically how long the discomfort from simultaneous adrenaline symptoms lasts.

This is why we never think about rational fear. There is a cause, a danger, and we act. Once the danger has passed, we continue with our lives as if nothing happened. Rational fear is forgotten within an hour because we acted rather than panicked.

The opposite happens when we do not act in the situations described above. Instead, we panic over the sudden adrenaline discomfort. Such a panic experience is stored. The brain is wired to store negative experiences in order to learn from them. Panic is one of them.

This is the difference between rational and irrational anxiety. Rational fear is forgotten, irrational anxiety is remembered.

The problem with a stored panic reaction is that we begin to fear it happening again. We start thinking about the experience and how to avoid it. That is why we seek medical help. It is the fear of recurrence.

As mentioned, we store all unpleasant experiences. But with anxiety, there is a crucial difference.

In a conflict or a threatening situation, the source is external. You can point to it, explain it, leave it behind, and learn from it. With irrational anxiety, the source is your own body. That makes it harder to dismiss and explain in the absence of a visible cause, and therefore easier to fear again.

As you can see, the cause is not the problem. Not serotonin deficiency, genes, trauma, or any of the other explanations we are given. These explanations originate from a time when the role of adrenaline in creating discomfort was not understood. Therefore, the discomfort was explained in other ways.

All psychiatric explanations for anxiety produce the same discomfort because no action is taken in response to the symptoms they generate.

The sole cause of panic attacks is the lack of physical action in response to adrenaline. If you had jumped in place for 30 seconds when you first felt the symptoms, there would have been nothing to remember, only the normal discharge of released adrenaline.

Irrational anxiety does not simply arise; it is created in the moment we fail to give the body what it is asking for when adrenaline is released, a reaction, an action.

Again, it does not matter what triggered the adrenaline, whether serotonin, trauma, genes, or something else. If the adrenaline is acted upon, panic does not occur. The evidence is rational fear.

Your response to adrenaline, the symptoms, determines whether it leads to a panic attack, not the cause.

Thomas Fogh Vinter