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Causes of Panic Attacks-That Sneaky Little Trigger

by Dr. Blumberg on January 11, 2011

Trigger One: Anticipatory Anxiety

*After your first panic attack strike “Out of the Blue” that took you to the Emergency Room, you live in dread of future attacks.  The dread of recurring panic attacks leads to a series of triggering anticipatory anxiety thoughts.

The Six Most Common Anticipatory Anxiety Thoughts That Can Trigger a Panic Attack

  • “What if it happens again?”
  • “What if it happens in a trapped situation, where I can’t escape quickly to get help”
  • “I hope I never feel like that again!”
  • “I will avoid caffeine, because it might trigger panic attack symptoms”
  • “It is so great. I have not had an anxiety attack in one month”
  • “I hope I have a good day today?

How Can Thoughts Trigger a Panic Attack?

Panic attacks are associated with terrify false catastrophic outcomes.

The Five Most Common False Catastrophic Thoughts associated with a Panic Attack

  • Die
  • Heart Attack
  • Lose my Mind
  • Faint in Public
  • Suffocate

The Brain Believes You, Even If You Are Wrong

The fear of a panic attack is connected to terrifying false catastrophic fears.  In the height of a panic attack, the panic attack sufferer believes the terrifying thoughts are true. The brain cannot differentiate between a true life threatening circumstance and a false perception of emergency. If you believe you are facing an emergency even if it is a false alarm, you send the same alarm input to the brain.  The alarm input sets off an emergency alarm and the brain discharges a chemical called adrenaline to mobilize you for imminent danger.  Adrenaline produces hundreds of different panic attack symptoms.

The Sneaky Little Trigger, Exposed

The Anticipatory Anxiety Thought “What if I have another panic attack?” is an obvious, easy to recognize, triggering thought. However, the thought “It is so great to be free of panic attacks” can also be a powerful anticipatory anxiety trigger.  When panic attacks subside, naturally, the hope is to never experience another panic attack again.  Unfortunately, once you are panic free, it is very common to forget how you got there.   It is easier to achieve a panic free state, than to stay panic free. Over time, reverting back to fearing and dreading panic attack symptoms is quite common. This returning fear of anxiety attacks can lead to devastating setbacks.

“The Before” and the “Right After”-But What about the “After Years”

A similar learning process occurs with all habits of change.  For example, it is common for highly motivated individuals to embark on a process of weight loss for a specific event or occasion.  The initial weight loss can be substantial. However, often times, after reaching goal, there is a tendency to resume old dietary patterns unless an intensive maintenance program is implemented and followed. Long term follow up studies show that over time, much of the original weight loss can be easily regained.

The same learning model holds true for mastery of panic attacks. Overcoming the fear of panic attacks can help you reach a panic free state.  Once you reach a panic free state, there is often a tendency to slip into the old habits that Claire Weekes calls the “Fear of Fear.” Then, discouraging setbacks are not too far behind.

Staying Panic Free and the Sneaky Little Trigger

Overcoming the fear of panic attacks with a scientifically grounded Cognitive Behavioral Treatment Program is phase One of a Four Phase Comprehensive Program to stay panic free.  Do not let the thought “I hope I don’t have another attack” creep into your mind.  This form of thinking can lead to the fear of another attack and the anticipatory anxiety trigger.  Before you know it, you can find yourself struggling with panic attack symptoms again.

Just as much attention and effort needs to be paid to staying panic free as is paid to achieving the panic free state.  Naturally, discovering, understanding and mastering your four panic attack triggers and the core trigger-four is the key to living panic free.

The ideas in this blog are developed from Dr Blumberg’s panicLINK Program.  PanicLINK is a comprehensive, twelve session, four phase, multi-media educational program on panic disorder. The material in this Blog and the panicLINK Program are copyright protected by Out of the Blue Network, LLC. No permission is granted to reproduce this blog for commercial purposes. For more information, connect at

*This educational information should be used in consultation with your doctor to confirm a diagnosis and to review available treatments for panic disorder.

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