Did that panic attack really come from out of the blue? Nope.

They can seem like they come with no forewarning, for no reason, but there's a back story to every panic attack. It might involve caffeine or alcohol or other drugs, or a period of heightened stress, or a genetic predisposition to panic. We know these things. Now we also know that panic attacks are presaged by measurable physiological activity. According to a new Atlantic article:

Though those who panic don't realize it, their attacks are in fact foreshadowed by minute physiological signals, according to a study led by Southern Methodist University's Alicia Meuret in the journal Biological Psychiatry. "The hour before panic onset was marked by subtle but significant waves of changes in patient's breathing and cardiac activity, not just the moment of onset of the attack or even during the attack," she says. "Our analysis provided us with a whole different pattern."

That pattern goes like this: Physiological instabilities occur in repeated bouts or waves and are often initiated by heart rate accelerations, followed by changes in breathing and carbon dioxide levels. Ultimately, breathing becomes much shallower, causing a spike in carbon dioxide levels that lead to symptoms that could no longer escape the attention of those who panic. More precisely, they experience terrifying sensations, such as dizziness, air hunger, and shortness of breath.

...the researchers could still not determine why sufferers are unable to perceive panic attacks earlier. But some clues did emerge from the physiological patterns they observed. During recurring bouts, the body may be silently fighting off physiological instabilities that "return to a baseline but then restart," Meuret says. As a result, only one wave of disruption, the one that could no longer be pacified in secret, is felt. A gradual crescendo of anxiety never occurs, and the panic attack appears to have come out of nowhere.

UCLA anxiety expert Emanuel Maidenberg says this research may inspire new coping methods. He says since autonomic arousal symptoms precede awareness, the therapeutic practice of identifying and reexamining fears may potentially be initiated earlier, so patients could pursue threatening activities head-on.

The more we pay attention, it seems, the earlier we may be able to get started heading off panic at the pass. Perhaps even more important: While the physiological changes leading up to panic may continue during the attack, they're no more dangerous than what's come before:

...the researchers did not find any indications that physical changes during panic attacks were all that extreme. Meuret says that the fluctuations in heart rate and breathing were significant, but they never spiked to damaging levels....

So would telling the anxious that 'the worst is over' when they panic help? Yes, says Meuret. "Based on our findings, this would indeed be very true."

So, you know, yay panic!

Photo credit.

The best of PANIC!: A Buddhist perspective on coping with anxiety.

I've decided it's time to occasionally republish the more popular PANIC! posts from the past so that newer visitors to this blog will get a chance to weigh in on them. Following is the first such blast from the past, complete with comments to date (you can view the original post here). Please feel free to join the conversation!:

A Buddhist perspective on coping with anxiety.
The website of the Buddhism Society at Brown University has an article by Venerable Thubten Chodron entitled "Dealing With Anxiety" [note: this article is now available here], which posits that anxiety is caused by our natural inclination towards self-centeredness:

If somebody else's car gets dented we say, "Well, that's too bad," and forget about it. But if our car gets dented, we talk about it and complain about it for a long time. If a colleague is criticized, it doesn't bother us. But if we receive even a tiny bit of negative feedback, we become angry, hurt or depressed.

Why is this? We can see that anxiety is very intricately related to self-centeredness. The bigger this idea that "I am the most important one in the universe and everything that happens to me is so crucial," is, the more anxious we are going to be. My own anxious mind is a very interesting phenomena. Last year, I did a retreat by myself for four weeks, so I had a nice long time to spend with my own anxious mind and know it very well. My guess is that it's similar to yours. My anxious mind picks out something that happened in my life -- it does not make a difference what it is. Then I spin it around in my mind, thinking, "Oh, what if this happens? What if that happens? Why did this person do this to me? How come this happened to me?" and on and on. My mind could spend hours philosophizing, psychologizing and worrying about this one thing. It seemed like nothing else in the world was important but my particular melodrama.

When we are in the middle of worry and anxiety regarding something, that thing appears to us to be incredibly important. It's as if our mind doesn't have a choice -- it has to think about this thing because it's of monumental significance. But I noticed in my retreat that my mind would get anxious about something different every meditation session. Maybe it was just looking for variety! It's too boring to just have one thing to be anxious about! While I was worrying about one thing, it seemed like it was the most important one in the whole world and the other ones weren't as important. That is until the next session arrived, and another anxiety became the most important one and everything else was not so bad. I began to realize it isn't the thing I am worrying about that is the difficulty. It is my own mind that is looking for something to worry about. It doesn't really matter what the problem is. If I'm habituated with anxiety, I'll find a problem to worry about. If I can't find one, then I'll invent one or cause one.

One means to coping with anxiety is to adopt a perspective that goes beyond just yourself:

By meditating on the kindness of others, we will see that we have actually been the recipients of an incredible amount of kindness and love from others. In doing this meditation, first think about the kindness of your friends and relatives, all the different things that they have done for you or given you. Start with the people who took care of you when you were an infant. When you see parents taking care of their kids, think, "Somebody took care of me that way," and "Somebody gave me loving attention and took care of me like that." If nobody had given us that kind of attention and care, we wouldn't be alive today...

...Think about the incredible kindness we received from those who taught us to speak. I visited a friend and her two-year-old child who was learning to speak. I sat there, watching as my friend repeated things over and over again just so her child could learn to speak. To think that other people did that for us! We take our ability to speak for granted, but when we think about it, we see that other people spent a lot of time teaching us how to speak, make sentences, and pronounce words. That is a tremendous amount of kindness we have received from others, isn't it? Where would we be if no one taught us how to talk? We did not learn by ourselves. Other people taught us. Everything we learned throughout childhood and everything we keep learning as adults -- every new thing that comes into our lives and enriches us -- we receive due to the kindness of others. All of our knowledge and each of our talents exist because others taught us and helped us to develop them.

It may or may not help you achieve enlightenment, but this sure seems like worthwhile advice.