Which comes first–panic attack symptoms or physiological changes?
It is easy to see how the symptoms of panic attacks can be produced by the physiological changes caused by a fight-or-flight response. But which comes first? Suppose a potential panic attack sufferer has a slightly elevated sensitivity to internal chemical and emotional changes. This individual is hyperventilating, ever so slightly, without knowing it so that the Ph level in the blood is slightly askew. This person is outside on a very hot day doing something physical. She stands up too quickly or turns around too quickly, and suddenly she feels a bit dizzy. Most people would say, “It is a hot day. Maybe I need to get a cool drink and sit in the shade for a few minutes.’ The person prone to panic attacks will say, ‘I’m dizzy,–what is wrong with me? Am I going to pass out?’ The fear escalates, adrenaline is released, symptoms increase, and panic has arrived. The next time the person considers going outside on a hot day she thinks, ‘Oh, oh, I had trouble with that last time, and I got a
