What Causes Panic Attacks?

by Dave Carbonell, PhD

Most people who struggle with panic want very much to know what causes panic attacks. There are really two questions here, and I will answer them both in this article.

The first one is what causes an individual anxiety attack. This is very important because once you know how panic attacks work, you will be in a good position to free yourself from panic attacks.

The second version of this question has a very different meaning. When people ask "what causes panic attacks?", they often don't mean an individual attack. They want to know "why" they have this problem. They frequently ask themselves the "Why?" question, especially when they are having a panic attack.

How Panic Attacks Work

This includes such questions as:

* What triggers a panic attack?

* What causes panic attacks to happen on some days, and in some situations, but not others?

* Why would I have a panic attack one time I visit the grocery store or drive on a highway, and not at the same place another day?

* Why do I have less trouble if my support person is with me?

* How do panic attacks end?

For a discussion of this question, I am making available here a free copy of Chapter 7 (The Panic Cycle) from my Panic Attacks Workbook. Feel free to download this chapter for your own personal use.

Click here to view or download the chapter.

The "Why?" Question

I tell my patients that the "Why?" question isn't helpful during an attack for several reasons:

* when most people ask themselves this question, they usually do it in an angry way, and are really just getting mad at themselves rather than seriously looking for answers.

* it's unlikely that you will actually find an answer to this question, especially during a panic attack.

* even if you did find an answer, that wouldn't stop the panic attack. You would just be a more informed person having a panic attack!

When you are actually having a panic attack, the "Why?" question is of little value, because it diverts you from what you can do to help yourself in that moment. However, there are two questions that are very valuable during a panic attack, and these are the ones I urge you to use whenever you experience a panic attack.

The Helpful Questions

1. "What's happening now?"

2. "How shall I respond to it?"

The questions What? and How?", much more than "Why?", can help lead you to helpful, coping responses during an attack. As you learn how to work "with" rather than "against" a panic attack, you will learn how you can make these questions work for you.

The free chapter from my Panic Attacks Workbook will help you understand what causes panic attacks. More importantly, it will help you figure out how to respond to panic attacks so as to calm them and bring them to an end.

But, if you're like most people with panic, you're still going to find yourself asking "why?'. So here's a general explanation of what causes panic attacks to be a problem for some people, and not for others. I hope it will give you enough of an understanding of what causes panic attacks to be a problem for you to enable you to move on to the questions of "What and How?" rather than "Why?".

Underlying Factors:
What Causes Panic Attacks

Genetic Predisposition

The first is that there is almost certainly a genetic predisposition to panic attacks. Some people are born likely to develop panic attacks under the right circumstances, and some people couldn't have a panic attack if you paid them. We're all born with a variety of innate tendencies. If you have panic attacks, this is one of yours.

Anxious trends during childhood

A second reason why people develop panic attacks is that as children, they may have grown up in an atmosphere which, for one reason or another, failed to teach them that the world was "their oyster", a safe place in which they could happily pursue their own enjoyment. Maybe there was an early death in the family, severe illness, or some other serious problem like alcoholism or divorce. Maybe the parents were themselves anxious and over protective, perhaps in response to their own anxiety disorder. Perhaps the child learned to spend too much time and effort taking care of others, trying too hard to please others, and feeling responsible for the happiness of others.

A Response to the challenge of emerging adulthood

The third reason why people develop panic attacks is that they often experienced a period of high stress and stressful changes in the year or so prior to the onset of the panic attacks. These might have been bad events, such as feeling trapped in a bad job or relationship, or experiencing the loss of family and/or friends. Or they may have had a lot of changes which weren't bad in themselves - finishing school, changing jobs, getting married, moving, buying/selling a home, having babies, etc. - but which had a cumulative stressful effect on the person to the point that he/she found it hard to cope with them all.

It's interesting to note that, for most people who develop panic attacks, it usually begins in their twenties or thirties - the years of establishing an independent life for yourselves when you are most likely to experience these kinds of changes.

What These Factors have in Common

What causes panic attacks to invade a person's life? Genetic predisposition, early childhood experience with anxiety and risk, and challenging changes on becoming an independent adult.

What these three factors have in common is that none of them were under your own control. These are all developmental events in life which happen to some people. The factors which cause panic attacks are not something you could have controlled.

There is therefore no reason to feel guilty, ashamed, or apologetic about having panic attacks. They are not the result of living badly; or of making bad choices; or of being "stupid", or cowardly.

Your Problem, not your Fault

If you have Panic Disorder, then panic attacks are your problem...to solve or leave unsolved...but don't be confused into thinking that panic is your fault.

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