A redistribution of blood from areas that aren’t as vital to those that are, such as away from
skin, fingers and toes towards large vital organs. Your skin might look pale or you might feel cold, or
there might be a feeling of numbness and tingling in your fingers and toes.
An increase in sweating causes the body to become more slippery, making it harder for a predator
to grab, and also cooling the body, preventing it from overheating.
Widening of the pupils of the eyes lets in more light and enables you to better scan the
environment for danger. You may notice blurred vision, spots before the eyes, or just a sense that the
light is too bright.
Decreased activity of the digestive system allows more energy to be diverted to fight/flight
systems. A decrease in salivation may leave you with a dry mouth and decreased activity in the digestive
system may lead to feelings of nausea or a heavy stomach.
Muscle tension in preparation for fight/flight results in subjective feelings of tension, sometimes
resulting in aches and pains and trembling and shaking. The whole physical process is a comprehensive
one that often leaves the individual feeling quite exhausted.
As you can see, these physical alarm responses are important when facing danger, but they can also occur
when there is a false alarm, when there is no danger.
Hyperventilation and anxious breathing
You probably already know that we breathe in to obtain oxygen and we breathe out to expel carbon
dioxide. The body naturally maintains optimal levels of oxygen and carbon dioxide, and this balance is in
part maintained through how fast and how deeply we breathe. When we exercise, for example, we breathe
faster and more deeply in order to replace the oxygen being used and expel the extra carbon dioxide
produced by metabolic changes. Anxiety causes an increase in our breathing rate, as part of the physical
fight or flight response to a perceived threat. However, when our breathing rate increases without any
physical exertion, we breathe out too much carbon dioxide. If the body cannot quickly return carbon
dioxide levels to the optimal range, we experience further symptoms such as dizziness, light-headedness,
headache, weakness and tingling in the extremities and muscle stiffness.
Some people who have panic attacks may overbreathe, producing these sensations of anxiety. For people
with panic, these physiological sensations can be quite distressing as they may be perceived as being a sign
of an oncoming attack, or something dangerous such as a heart attack. We will discuss this in more detail
when looking at beliefs and cognitions about physiological sensations.
When we feel anxious or expect to feel anxious, we often act in some way to control our anxiety. One
way you may do this is by keeping away from situations where you might have panic attacks. This is called
avoidance, and might include:
• Situations where you’ve had panic attacks in the past
• Situations from which it is difficult to escape, or where it might be difficult to get help, such as public
transport, shopping centres, driving in peak hour traffic, places where medical help is not available
• Situations or activities which might result in similar sensations, such as physical activity, drinking coffee,
having sex, emotional activities such as watching horror movies or getting angry
What kinds of situations/activities do you avoid so as not to have a panic attack?
• Psychotherapy • Research • Training
Module 1: Overview of Panic