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Discover Your Four Panic Attack Triggers; Eliminate “Out of the Blue” Panic Attacks

by Dr. Blumberg on October 11, 2010

If you are like over 5000 of my panic disorder patients, then your first panic attack struck you “Out of the Blue” with no apparent reason. An unexpected onslaught of intense heart pounding, shallow breathing, head pressure, weakness, hot/cold flashes and rubbery legs can be so frightening that you are convinced you are dying or losing your mind. Immediate medical attention is often the first option. When you learn there is no medical cause for these powerful physical symptoms, you want an answer.

 What Is Happening to Me?

 My patients wonder:

1)      Why am I feeling this way?

2)      Why me?

3)      Why now?

4)      What is causing me to feel this way?

5)      What if the doctor missed something?

6)      When will these symptoms go away?

7)      Will these symptoms ever go away?

 Uncertainty and doubt about the cause of panic attack symptoms can leave you confused and shaky. Learning that your heart pounding and shallow breathing is not a symptom of heart disease is only half the battle.  The major challenge you face is to convince yourself that the heart pounding is a natural normal sensation of adrenaline. 

 You can strengthen your understanding of the causes of panic disorder and enhance your control of panic attacks as you begin to identify your four triggers for panic attacks.

 The Four Triggers for Panic Attacks

 1)      Panic Trigger One: Anticipatory Anxiety (AA) The thought “What if I have another panic attack…”

You have to drive into Manhattan at rush hour.  You think “What if I get caught in traffic and can’t get out and I faint at the wheel!” The AA thought (the fear of a panic attack) can send an alarm message to the brain and activate the fight or flight response, producing adrenaline. Even before you get into the car, you can feel heart pounding and lightheadedness.

 2)      Panic Trigger Two: Trapped situations, where you cannot immediately escape to a place of perceived safety

Common trapped situations include waiting at the doctor’s office, hairdresser appointment, heavy traffic on the highway, far from an exit, and a long line in the marketplace.  If you rely on escape or avoidance of trapped situations as your primary method of panic attack relief, then trapped situations will be a reliable Panic Trigger.

 3)      Panic Trigger Three: Panic Imitators

If you are a panic attack sufferer, you can become afraid of your own natural bodily reactions. Normal physical feelings can fool you into thinking something is wrong.  For example, you bend down and get up quickly and feel the sudden rush of dizziness like we all do….but you think “Oh no, what if I faint?” Normal feeling of dizziness due to exercise can intensify. You can have a panic attack on top of the normal physical feelings associated with bending over and getting up quickly.  Common panic imitators include caffeine, humidity, and a hot stuffy room.

 4)      Panic Trigger Four: Blocked Strong Emotions associated with Loss/Separation, Illness, Sickness and Chronic Interpersonal Conflict

This core panic trigger four is the most important trigger to discover and the most difficult to identify. It is a very complex trigger that involves understanding your four factor pre panic personality profile.  See the Out of the Blue Blog for more information on your four factor pre panic profile. Panic Trigger Four is usually the underlying trigger for the First Panic Attack “Out of the Blue” and the trigger for The Recurrence of panic attacks, after living panic free. This Trigger is the link to maintaining a panic free life. 

It will take time and personal research to see the triggering contexts for your panic attack symptoms. As you make the link, the physical symptoms of a panic attack become understandable and blend into life.




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