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What Causes Panic Attacks and Phobia

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This is the story of Patricia and her story shows how panic attacks and phobias typically start. Some of the key causes are: (1) stressors, (2) pre-disposing factors, (3) fearful thoughts, (4) your nervous system and brain becomes conditioned to trigger a fear response in a specific situation.

You'll also find info on how to overcome panic attacks and phobias and helpful resources.

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What Causes Panic Attacks and Phobia

  1. 1. WHAT CAUSES PANIC ATTACKSANXIETYHUB.ORG | DR. CHERYL MATHEWS
  2. 2. Patricia’s Story Patricia is 15 years old and her family lives in a rural area. Her parents get divorced. Her mother moves Pat and herself back to the city where her mother grew up. Her mother enrolls Pat in a small, private school half-way through her 10th grade semester. Pat's mother went to this school, and got straight A's and expects Pat to do the same. Pat's parents are perfectionists and put pressure on her to have top grades, speak with proper grammar, excel at piano, and have strong social skills. Pat's parents want their community to view them as a perfect family. No one in the family shows negative emotions in public - or in the family for that matter. For the most part, Pat lived up to her parent's expectations, and performed well academically and socially. She developed high expectations of herself. A few years back, Pat's father was taken to the hospital for what he thought was a heart attack - it turned out to be a panic attack. The students at the new school are cliquish. Many of them have gone to this private school since 1st grade and the students know each other well and are not friendly to new students. The students are critical, snobby, and merciless to those who don't fit in. Pat feels like an outsider. Pre-disposition Stressor Stressors 2 Pre-disposition
  3. 3. Patricia’s Story On Pat's first day in school, she was nervous, but she introduced herself to the class with not too much problem. But throughout the semester, she develops more and more anxiety in her English and History classes where she has to do a lot of reading out loud and group discussion. In the group discussion, she feel like the students are smarter than her. During one class, she is not well prepared and the teacher calls on her. She thinks "oh, my god, this is terrible, I'm not prepared. I will look like a complete fool. School is already unbearable - now it will only get worse.." She blushes, her heart starts to race, she starts trembling, sweating and stammering. Her throat and chest tighten, and she can’t swallow or catch a breath. She then freezes, and her brain shuts down. She can’t think clearly. What can I do to get out of this unbearable situation? She panics. She runs out of the room flustered, humiliated, and ashamed. 3 Fearful thoughts; perception of threat Body reacts involuntarily
  4. 4. Patricia’s Story She goes to hide in the restroom to give herself a minute to process what just happened. She feels distress, confusion, humiliation, and shame. She tells the school nurse that she’s sick and needs to go home. Her mother picks her up and brings her home. Pat goes to her room and lies down on her bed. Deep distress builds as she tries to make sense of the event but can't. She wonders "What just happened to me? Why did it happen? It happened suddenly out of the blue. Something is deeply wrong with me. I used to be able to speak in class but I can't now. I can't face school. I need to escape. She realizes that she can avoid the situation for a few days by pretending to be sick, but she’s going to have to face school soon. She dreads going back and obsesses about it. Not only will she be reminded of her humiliation - she will soon find herself in another group discussion, and the same thing will happen again. Her dreams of having friends, fitting in, running for school office, finding a boyfriend, and making her mother happy all seem shattered. These thoughts make her extremely anxious and distressed. She does not share any of this with her mother because she is too embarrassed. 4 Distress, confusion, shame, worry about the future; dread of facing situation again
  5. 5. Patricia’s Story Three days later her mother tells her that she has to return to school. This is the day she has been dreading. At school she avoids people and tries to blend into the walls. She is deeply anxious in English and History class, and does not participate in discussion. Her lack of participation lowers her grade, but this option is better than experiencing the uncontrollable, escalating anxiety she experienced a few days ago. The next time she is called on she knows the answer, but her brain freezes. 5 Anxiety piles on and escalates; she feels hopeless and out of control Happens again Another humiliation. Every day is deeply painful and she sees no light at the end of the tunnel.
  6. 6. Summary of Events Causing Phobia Public SpeakingAnxiety Program Case Study: Patricia Patriciais 15 years old and her familylives in a rural area. Her parents get divorced. Her mother moves Pat and herself back to the city where her mother grew up. Her mother enrolls Pat in a small, private school half-way through her 10th grade semester. Pat's mother went to this school, and got straight A's and expects Pat to do the same. Pat's parents are perfectionists and put pressure on her to have top grades, speak with proper grammar , excel at piano, and have strong social skills. Pat's parents want their communityto view them as a perfect family. No one in the family shows negative emotions in public - or in the familyfor that matter. For the most part, Pat lived up to her parent's expectations, and performed well academicallyand socially. She developed high expectations of herself. A few years back, Pat's father was taken to the hospital for what he thought was a heart attack - it turned out to be a panic attack. The students at the new school are cliquish. Many of them have gone to this private school since 1st grade and the students know each other well and are not friendlyto new students. The students are critical, snobby, and merciless to those who don't fit in. Pat feels like an outsider. On Pat's first day in school, she was nervous, but she introduced herself to the class with not too much problem. But throughout the semester, she develops more and more anxiety in her English and History classes where she has to do a lot of reading and group discussion. In the group discussion, she feel like the students are smarter than her. During one class, she is not well prepared and the teacher calls on her. She thinks "oh, my god, this is terrible,I'm not prepared. I will look like a complete fool. School is already unbearable - now it will only get worse.." She blushes, her heart starts to race, she starts trembling, sweating and stammering. Her throat and chest tighten, and she can’t swallow or catch a breath. She then freezes, and her brain shuts down. She can’t think clearly. What can I do to get out of this unbearable situation? She panics. She runs out of the room flustered, humiliated, and ashamed. She goes to hide in the restroom to give herself a minute to process what just happened. She feels deep distress, confusion, humiliation, and shame. She goes to the infirmaryto tell them that she is sick and needs to go home. Shortly thereafter, her mother picks her up from school and brings her home. Pat goes to her room and lies down on her bed in shock. Deep distress builds as she tries to make sense of the event but can't. She asks "What just happened to me? Why did this happen? It came so suddenly out of the blue. Something is deeply wrong with me. I used to be able to speak in class, and now for some reason, I can't anymore. I can't face anyone at school again. I need to figure out a way to get out of that school." Hours go by and Pat has no answers and no solution. She can't think of a way of getting out of this school - except running away, but she can't bear that alternative, so she feels trapped in a nightmarish situation. She realizes that she can avoid the situation for a few days by pretending to be sick, but she is going to have to face her class again soon. She dreads going back to school and obsesses about it. Not only will she be reminded of her humiliation - she will soon find herself in another group discussion, and the same thing will happen again. Her dreams of having friends, fitting in, running for school office, finding a boyfriend, and making her mother happy all seem shattered. These thoughts make her extremelyanxious and distressed. She does not share any of this with her mother because she is too embarrassed. Her mother would probe her about what is causing it and she has no answers. At dinner she hides her distress and emotions. Three days later her mother tells her that she has to return to school. This is the day she has been dreading. At school she avoids people and tries to blend into the walls. She is deeply anxious in English and History class, and does not participatein discussion. Her lack of participation lowers her grade, but this option is better than experiencingthe uncontrollable,escalating anxiety she experienced a few days ago. She prepares for each class. The next time she is called on she knows the answer, but her brain freezes and she blurts out a short sentence that doesn't fully answer the question. The teacher says "is that it?" and Pat says "that's it.” Another humiliation. Every day is deeply painful and she sees no light at the end of the tunnel. 1. Pre-disposition(s) 2. Stressor(s) 3. Fearful thoughts; perception of threat 4. Body reacts involuntarily 5. Distress, confusion, shame, worry about the future; dread of facing situation again 6. Happens again 7. Anxiety piles on and escalates; confirms something is wrong with her; feels hopeless and out of control 2. Stressor(s) Part I: Initial Conditioning Part II: Conditioning is reinforced 6
  7. 7. Key Take Aways • There are usually stressors at the beginning of a phobia. Stress has a way of making us feel shakier and more vulnerable. It’s in our moment of weakness that phobia and panic swoops in • There are usually pre-disposing factors such as: – You were bullied – You had over-protective parents – Anxiety runs in your family – Your family or friends modeled anxious behaviors – Others... 7
  8. 8. Key Take Aways • Fearful thoughts create the phobia and maintain the phobia • Confusion about the unexplainable intensity of the fear keeps you ruminating about what happened and why – Confusion creates a continual cycle of distress and diminishes self-confidence – One of the goals of Anxiety and Phobia Programs is to explain what’s going on. This begins to unravel the mysteries and stop the confusion. 8
  9. 9. Key Take-Aways • Your nervous system gets conditioned. This means that your nervous system will automatically and uncontrollably trigger a fear response the next time you’re in that situation (or similar situations) • The goal of Anxiety and Phobia Programs is to gradually decondition and desensitize your nervous system so you no longer automatically and uncontrollably trigger a fear response in that situation (or similar situations) 9
  10. 10. Key Take-Aways To overcome panic and phobia • Focus on deconditioning and desensitizing your brain and nervous system. • Your nervous system and brain are programmed to automatically trigger an intense fear response in a particular situation. • The goal is to re-program your nervous system and brain so you’re not automatically triggering an intense fear response. 10
  11. 11. Key Take-Aways To overcome panic and phobia • Deconditioning involves working with a cognitive- behavioral (CBT) professional and gradually exposing yourself to the feared situation. • This is not where you’re gritting your teeth and going into the feared situation unprepared or alone! Instead, this is a very planned approach where you learn proven panic-management techniques and coping strategies. You very gradually and sensitively face a fearful (but safe) situation where you have escape options. This is best done with a professional GUIDE who is an expert in gradual deconditioning. 11
  12. 12. Key Take-Aways To overcome panic and phobia • Understanding the pre-disposing factors in your history will NOT help you overcome the panic or phobia. • We recommend NOT spending a lot of time analyzing your history (pre-disposing factors, stressors). It’s interesting...but should not be the focus of your recovery work. Stay focused on the present and future by working on deconditioning and desensitization. 12
  13. 13. More Info  Anxiety treatment centers (Anxiety and Phobia Programs) http://anxietyhub.org/best-anxiety- treatment-centers/  Virtual counselors and help http://anxietyhub.org/anxiety-treatment-virtual- counselors/  Social anxiety and public speaking phobia coursehttps://speakmeister.com/edu/master- your-public-speaking-fear/ 13

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