What happens in the body and brain during a panic attack?

Mark
Written By Mark

The heartbeat accelerates, the hands shake, and breathing becomes more difficult. If a person is overcome by a feeling of fear, his body’s reaction may be a panic attack. Such a seizure comes violently, and some who experience it may feel as if they are dying. In Germany alone, on average, about 30% of people suffer from a panic attack in their lifetime, said Andreas Strohl, head of the anxiety treatment unit at the Charité Hospital in Berlin.

On the occasion of World Mental Health Day, corresponding to Thursday, October 10, a look at the numbers of German health insurance companies reveals that cases of anxiety and related diseases are on the rise. According to the German health insurance company (DAK-Gesundheit), the number of days absent from work due to psychological illnesses such as depression or anxiety disorders rose sharply in the first half of 2024.

The health insurance company (IKK) believes that the percentage of those suffering from anxiety disorders among the insured has risen to more than 37% in 10 years, as the company announced last year.

Dr. Strohl describes panic attacks as the body’s own alarm system, explaining, “You can imagine it as a bit like an alarm sounded by a warning system. This goes from 0 to 100 very quickly and then slowly decreases again,” adding – on the other hand – that The course of panic attacks is not the same, and they are not always due to a psychological illness.

What happens in the body and brain during a panic attack?

Strohl says that during a panic attack, certain areas of the brain are activated, adding that “the brainstem and the physiological centers in the brain that regulate blood circulation and breathing are responsible for these physical reactions,” explaining that these centers are partly responsible for reactions such as an accelerated pulse, shortness of breath, or Sweating.

When these processes are launched, a massive alarm reaction occurs in the body. According to Strohl, this leads to “the body being prepared for a major threat, reactions such as fight or flight are easier, and the muscles are better supplied with blood,” explaining that this allows the body to respond as much as possible to a potential threat.

The expert explains that if the attack runs its course, the symptoms vary, and he said, “Shortness of breath, hyperventilation, or rapid breathing are classic symptoms of a panic attack, but their occurrence is not inevitable.” Sometimes those affected also suffer from sweating, agitation, or an increased desire to urinate. Patients also talk about the fear of losing control, going crazy, or even death.

A panic attack is not the same as panic disorder

But why do these panic attacks happen? Strohl cites, among other things, psychological and physical illnesses, life events, and drugs such as alcohol or tranquilizers among the causes. Some risk factors also increase the likelihood of panic attacks, such as increased coffee consumption, lack of sleep, stress, or certain medications.

The expert pointed out that there are also seizures that occur for circumstantial reasons, such as if a person suffers from a pathological fear of snakes and finds himself in a confrontation with this animal, then he may have a panic attack. “In terms of symptoms, it can be similar to panic disorder, but it is triggered by certain situations or sometimes by a thought about them,” Strohl says.

The expert explained that it is important to distinguish between a panic attack and panic disorder, noting that a panic attack can also occur in healthy people during life-threatening situations or in the event of exposure to a strong threat, for example. He said: “When I – as a healthy person – face… “Good–Snake, I know it’s completely normal for me to react this way.”

Highly sensitive alarm system

Panic disorder is characterized by recurring, unexpected panic attacks, according to Strohl. “This prompts those affected to avoid certain situations and activities, withdraw socially or develop more fear,” the expert says, adding that what happens next can be described as a “highly sensitive warning system.”

However, it is still unclear how common panic disorder is in Germany. The German Society for Psychiatry, Psychotherapy, Psychosomatic Medicine and Neuroscience explains that the most recent data collected on the frequency of this diagnosis in Germany goes back several years. A study conducted in 2014 showed that about 2% of the population suffered from this disease at that time.

In this context, Strohl says – based on his experience in the anxiety treatment unit in Charité – that this disease can be treated easily, explaining that one can resort here to psychological treatment, especially behavioral therapy, and during this one can use antidepressants or be satisfied with them alone, stressing that The chances of success of such treatment are very high.