What are the key factors that take you from mildly anxious to a full blown panic attack?

1. It all starts with hypervigilance to threat. This means we are constantly on the lookout for signs that we might not be safe. When we search, then we find something to trigger that threat response.

2. Some signs of anxiety arise and our attention zooms in on it. Focusing on the symptoms of anxiety can actually make them worse because anticipate it getting worse. We fear the fear. So the first sign of that pounding heart or shortness of breath becomes a source of fear itself.

3. Next comes desperate attempts to stop the anxiety and make it all go away. But when we are not willing to feel something, we definitely will. So then we feel out of control, which is another source of fear. Cue the increase in anxiety.

4. This final factor is key to triggering a panic attack. The catastrophic misinterpretation of the harmless symptoms as something dangerous. For example, my throat is tight, “I’m going to suffocate” or “my heart is pounding, I’m having a heart attack. I’m going to die”. Others might be based on psychological threats such as, “I will vomit or pass out and everyone will judge me. I will be humiliated”. None of these predictions are fact. They are thoughts we buy into which lead us to feel terrified and completely out of control.

Let me know in the comments if you would like more detail on this or a video on what to do to stop a panic attack.