The Biochemistry of Panic

by Mark Sichel, LCSW

Many people who have problems with anxiety and stress seem to have a heightened sensitivity to the environment and react more strongly to the stimuli around them. In some people, there may exist what's called a "deficit in their stimulus barrier," in other words, noises, action, movement, smells and sights in their surroundings may be more difficult for them to shut out than it is for most people.

Well, this would seem to suggest that panic attacks are biological in nature. Yet everything we've discussed so far has pointed to environmental and developmental causes of panic attacks. Could it be a combination of the two?

Are Panic Attacks Biological or Mental?

There are those who would make the argument that panic disorder is solely a biological phenomenon, whereas others would take the opposite stance and contend that panic is related solely to environment and developed personality traits.

Most practicing psychotherapists tend to view a problem like panic disorder as being related to both human anatomy and human psychology. The interplay between inherited genetic trends, brain chemistry and a given character style in a given environment is what creates a panic attack. For further evidence to support the biochemistry side of the argument, let's look at the crucial anatomical components.

The Brain:

The brain is one of mankind's most perplexing puzzles. Despite being shrouded in mystery, the brain is slowly beginning to reveal important facts about itself. Scientists are making advances daily in the study of the human brain and the role that biochemical factors play in contributing to the development of psychiatric disorders. The two parts of the brain that scientists have concentrated on the most so far in this respect are the neurotransmitters and the amygdala.

Neurotransmitters:

One biochemical explanation for panic is that there is an over-activity in what's called the locus ceruleus. The locus ceruleus is the part of the brain that triggers a response to danger. It's like our brain's alarm system. People who get panic attacks can be thought of as unwittingly sending alarms to this part of the brain. A trigger-happy locus ceruleus could wreak havoc with a person's perspective. We discussed "catastrophizing" in This is Not a Catastrophe in the context of behavioral choices. Faulty neurotransmitters would be a physical manifestation of "catastrophizing." The cause is different; the result is much the same.

What Happens After the Locus Ceruleus Sounds the Alarm?

Amygdala:

The amygdala is the part of the brain that holds old memories, feelings, sensations and emotions and then transmits this information to the rest of our bodies. It is in the amygdala that we store, among myriad other things, all of our primal memories of powerlessness and helplessness that we experienced during infancy and early childhood.

Well, when the neurotransmitters pick up over-activity in the locus ceruleus, the part of the brain that instructs us to run from danger, the amygdala hears the alarm, and instantly calls up the memories of past events that were dangerous and terrifying. The present danger may be, and most likely is, nothing compared to earlier dangers we've experienced, particularly the way we experienced danger as infants. But we nevertheless experience the fear as viscerally and as primally as we would if our very lives were at stake.

Many child development experts believe that early infancy can be a very scary time. Just imagine a 3-year-old playing in a sandbox, weighing about 40 pounds. He looks up and, instead of seeing his mother, can only -- even for a moment -- see other children and frightening adults all around him. Translate the weight difference into adult terms: for a tantamount experience you would have to be surrounded by a throng of beings who weighed 700 pounds each and stood 4 times as tall as you. That's exactly how minor dangers are perceived during a panic attack.

So, the amygdala goes into action, warning the heart to beat faster, instructing our breathing to become rapid, heightening all the biological components of the fight/flight response. Outcome: Full Blown Panic Attack.

Genetics of Panic:

There is some evidence of genetic pre-disposition to panic. About 20 to 25 percent of people with panic have close relatives with panic disorder. Often there is a deficit in the protein that transports serotonin, an important neurotransmitter in the regulation of mood and the ability to tolerate and process anxiety.

Another genetic defect that some people have is one which affects dopamine, another important neurotransmitter.

Other genetic mutations that affect other neurotransmitters are speculated about, but are not yet understood by medical science.

© Mark Sichel, LCSW


Mark Sichel, LCSW is a psychotherapist in private practice in New York City and a Licensed Clinical Social Worker. Mark is the author of Healing from Family Rifts, a guide to mending even the most difficult family estrangements, and how to reconcile with yourself if your family rift cannot be healed. More information can be found at www.marksichel.com. Visit the author's web site at www.psybersquare.com.