There are many people who have had a panic attack at some point in their life. Some are able to move past this experience and get on with their lives. However, others get stuck in this panic place. They continue to have multiple subsequent panic attacks and begin to live in fear of their panic symptoms. Eventually, what they think and do begins to change in the attempt to prevent more panic attacks. Once you get to the place where your daily life looks different because of the fear of panic, it is possible that you have developed panic disorder.
So why do some people develop panic disorder and others do not? There are three reasons why this happens: 1) Selective attention and hypervigilance; 2) Safety behaviors; and 3) Avoidance. This topic will be a three-part series. In this post, I will discuss how selective attention and hypervigilance can lead someone to move from a simple panic attack to panic disorder.
Selective attention and hypervigilance: It goes without saying (but I’ll say it anyway for emphasis, lol), that a panic attack can be extremely frightening. What feels like an explosion of multiple physiological symptoms hitting someone all at once is overwhelming and begs the question, ‘what is wrong with me?’ As a result of this experience, some people begin to selectively attend to their bodily sensations. They become hyper-focused on their bodies, constantly searching for some indication of an impending panic attack.
Here is an example. If you were afraid of dogs you would be on the lookout for them. You would especially be on guard in places where you have seen them before, such as at a park or on a walk in your neighborhood. Because you are keenly aware of their presence, you are more likely than someone else to notice them. Also, when you do see a dog, you would expect that the dog could harm you so you would watch them extremely closely to search for signs that they might harm you.
This is exactly what happens with panic. You begin to put all your energy into noticing any bodily changes, with the expectation that if you do notice bodily changes (a rapid heartbeat, difficult breathing, dizziness), then it means you are in harm’s way. However, just like with the fear of dogs, the more you focus on your physical symptoms, the more you will notice any changes. In addition, the more you focus on them, the more likely you are to actually increase the intensity of bodily sensations. When someone with a fear of panic begins to experience intense symptoms, their fear makes it difficult to think rationally and assume such symptoms are benign. The combination of the hypervigilance of bodily sensations and difficulty with reframing catastrophic thoughts can lead to what we call, ‘the vicious cycle of panic.’
