Usually a situation, person or creature will trigger a panic attack, however sometimes a spontaneous panic attacks can come out of the blue and be triggered

for no apparent reason

Here are a few points to consider -

Panic attacks which strike for no reason seem to affect people with anxiety disorders, depression and some people who have diabetes and asthma.  The condition is definitely made worse if you drink strong coffee or are abusing yourself with drugs such as amphetamines. (Amphetamine is a sympathomimetic drug that acts as a powerful central nervous system stimulant. Amphetamine use produces many effects including increased energy, increased alertness, euphoria and decreased appetite.)

dont panicPanic attacks can also been seen in alcoholics, people withdrawing from drug abuse and people with eating disorders.

There often does not seen any logical pattern to them.  Stressful events often make them worse, but even when someone is walking up stairs or using a computer this may be enough to trigger an attack in a person prone to having them.    They can come in clumps or at lengthy random times. 

The effects of the panic attack cause a strong urge to ‘escape’.  Therefore the individual will do what they think will make them better and runaway.    Of course the remedy should be to stay put and see the panic through and eventually the panic will die down.  The sufferer then needs to learn there is nothing to fear.  Although this sounds easy it can be very difficult to overcome as panic attacks can be unpredictable and frightening.

There is another problem with this condition.  The sufferer is not aware of any outside factors causing the panic, so they assume there is something really bad happening to them.  It is not usual for somebody to turn up in A&E clutching their chest thinking the worst.  Or after several visits to the doctor which revealed nothing, they still assume there is something wrong with them causing them to fear the worst.

People who do not accept they have an anxiety problem will often get well known at their local surgery in their desire to find the ‘real’ problem.  They often have tests for everything, multiple sclerosis, heart condition, brain tumour which of course comes back negative.  The person becomes hyper sensitive to every heartbeat, headache, nervous twitch, pain in their body, etc hoping to confirm that there inner belief that something is drastically wrong with them.  Therefore a cycle is happening.

The above describes me perfectly.  I went to the doctor several times before I was diagnosed with anxiety and panic attacks, but I still didn’t believe it.  THIS DELAYED MY RECOVERY BY SEVERAL YEARS!  I also ended in A&E after a day of extreme anxiety because I assumed something was terribly wrong with me.  I was just not functioning on any level.  Even simple tasks were becoming so difficult at the time – driving, concentration, talking to other people, eating in restaurants, etc.

I would also sometimes have spontaneous panic attacks.  At the start there didn’t seem to be a trigger but as I became more aware of how anxiety worked, I could see a pattern emerging.  For example strong coffee would always make me panicky or say 3 or 4 cups of tea.  Stress would also trigger it.  Diet would be a factor and the day after drinking alcohol a panic attack could trigger at any time.  There were other triggers as well. 

How to Stop a Panic Attack

The main thing to realize is once you are sensitized to certain situations panic attacks can trigger any time. Your brain interprets things before you even know it yourself.  Your body has become so hypersensitive to stress that at any time the simplest thing can cause the sufferer to have a panic attack.  A little thought, a similar situation that triggered an attack yesterday, a smell; literally anything.  Your body is tired, its not getting the right fuel, its over worked, mentally your on another planet, its no wonder you have fallen into this pit of despair and your trying frantically to climb out but your just creating a bigger hole. 

Its also worth noting that coming off medication can lead to what you believe is spontaneous panic attacks.  Again its just your body falling back into its old ways without the chemical fix. 


Treatment for Panic Attacks

Road block to recovery

When you feel you have hit a brick wall and you can’t seem to make progress getting better, then follow this technique.

Claire had been suffering panic attacks in several situations and mild agoraphobia.  One of these areas she was experiencing panic attacks was driving.  She had set herself a series of exposure programmes to desensitize herself.  She had managed to get into car and drive around the streets where she lived.  She then decided to go further afield.  After a few weeks she was capable of driving alone and even driving down a stretch of motorway.  But then she had a massive panic attack when she drove over a long bridge across a busy section of motorway.  It left her so shaken. She felt that everything that had gone before was wasted. 

How do you think we should help Claire?

If you ask the correct question you are much more likely to get a better answer.  The big question is WHY is Claire so scared about driving over a bridge?

The answer is probably this.

  • Claire finds that being stuck on a busy bridge frightening as there are no escape routes for her to leave easily. Whilst she has been driving on other roads she still had the opportunity pull over if she needs to.  But not on the bridge.
  • Heights have been a particular problem for Claire and when she looks over the edge of the bridge she realizes how high up she is it triggers panicky feelings.  

For Claire the best option is to treat bridges and heights as a phobia in itself and treat them accordingly.  So rather than just have exposure programme to beat her agoraphobia she needs to work on heights and being trapped in places where she cannot escape easily such as bridges, lifts, busy shops.   

The Agoraphobic Cluster

The problem with many agoraphobics is that they have a number of fears that are separate but related to everyday activities.  This is extremely common and one that you may recognise in yourself.  This is commonly known as the ‘agoraphobic cluster.’  The fears associated with an ‘agoraphobic cluster’ often have to be tackled separately to really overcome them.

The great thing about overcoming one fear is that they often help you overcome another fear.  Also once you have learnt to overcome one fear your confidence increases and you know what you need to do to overcome the next fear.   This may take more time but probably not more work.

What really causes Agoraphobia?

Agoraphobia effects people in different ways, but the overriding common feeling is feeling ‘trapped’ in a situation where they cannot easily escape to the safety of home, the car, outside, etc.  The ‘agoraphobia cluster’ comes in to the equation because the person may have panic attacks in different situations, but they relate to the same thoughts which are to do with the feeling of being trapped. 

The common fears include -

  • Enclosed environments such as lifts, boats, shops, cinema, trains, etc
  • Places where leaving is embarrassing the dentists, queues, meetings, hairdressers, etc.
  • Crowded places pubs, large shops, festivals, restaurants, etc.


Agoraphobics are often affected by other phobias which are linked to the above.

  • Environmental phobias, thunder, lightening, wind, anything that can make the person feel threatened and frightened to leave home.
  • Bodily phobias – blushing, heart attacks, strokes, vomiting, etc
  • Social phobias – eating in public or drinking in pubs.  Standing in crowds because their legs feel wobbly, making a fool of themselves in front of people, etc. 
  • Specific or simple phobias usually creatures such as dogs, birds, insects, reptiles, etc.

Avoiding danger is no safer in the long run than outright exposure. The fearful are caught as often as the bold.

Helen Keller


Dealing with Panic Attacks

Dealing with each fear at a time

If we take a crowded place like a shopping mall, you may have conquered your fears here but when you enter the cinema you may still feel frightened.  Although the places are similar (enclosed places with lots of people) your mind recognizes there different places and you may have different fears.  If you strip back and analyze the thoughts going through your head and get to the root of the fear, you can overcome it.  Think back to the example of Claire.

Remember it will get easier as you tackle each phobia.  You can use this technique to challenge and cure yourself of the next one.  Everyday keep working on challenging your fears.  Make it your goal or crusade if you like.  It’s a bit like building a pyramid.  The foundations take the longest but once this is achieved building it takes less and less time as you get near the top.  Never get disheartened when you think you cracked it and then you have a bad day.  It just means you need to keep working on that specific phobia.  Maybe you just had a bad day with stress or you didn’t stick to your diet. Its no big deal, tomorrow you will feel better. 

If we go back to our example Claire she will need to design a programme around exposure, relaxation, challenge thoughts, correcting faulty thinking, positive affirmation, diet, etc around her new phobias she has identified.  These being heights and feeling trapped.

Perhaps a strategy would be walk across bridges in increasing heights to build up confidence.  Then getting in the car and finding a bridge with a lay by and just stopping and waiting as long as its takes for the anxiety to subside.  Perhaps she could listen to music or read the paper on the bridge to distract herself and let her mind know its simply not important to her survival that she is on a bridge.  Do you see that by recognizing the issues, reinforcing the techniques (especially challenging your thoughts) shown in my program, and repeating this day after day, how you can overcome this.  All phobias are learnt behaviour.  You were not born with these irrational fears, they are just bad habits developed due to stress, faulty thinking, incorrect diet, etc.

The above makes its sound very easy to overcome phobias – its not.  It took me over ten years for the penny to drop of how much time, effort and dedication you have to put in to overcome this.  Below are some tips from the trenches that may help you.

  • Sometimes it’s really helpful to have a relative, friend or carer who can go with you when your exposing yourself to your fears for moral support.  Also when your anxiety levels rise to the point where you start to panic the carer must step in and reinforce that you are perfectly safe.  It’s at this point that you have to stay in the situation and not run away.  Tell your mind, body and soul you are not running away because you are perfectly safe. 
    -           Tell yourself when your calm,
    -           Tell yourself before you enter the fearful situation
    -           Tell yourself when you’re in the situation that


  • Take small steps in exposing yourself to your fears.  Watch how ‘normal’ people tackle your phobia. For instance in Clare’s case most people driving over a bridge would not give it a second thought.  Therein lies the crux of the matter.  This is what your working towards, totally forgetting your even driving over a bridge.  Most phobic's turn the phobia into some Armageddon event.  Remember for ‘normal people’ crossing a bridge would not even be notable enough for them to think about it.  The more you think about something in a negative way, the more power it has over you.
  • Sometimes just looking at whatever is causing your fears and improving your self-talk can really help.  If you stay, watch and get apprehensive about the thing you want to overcome then you’re doing the wrong thing.  If you stay and build up your confidence and take action then you are moving in the right direction. 

Simple phobias compared to complex phobias

James had a phobia of dogs.  He was shown pictures of dogs and although he didn’t like dogs he had no anxiety at looking at the pictures.  Next he went through an exposure programme of seeing dogs in the park, followed by being close to a dog and then being in the same room as a dog.  All this was going well until the dog was let off the lead and it started jumping up and down on him.  James had a panic attack and left the room.  

What seemed like a simple phobia has now turned into a more complex phobia.  Simple phobias tend to be of spiders, snakes, etc.  This is not too bad as don’t often come into contact with snakes and spiders very often.  Dogs on the face of it are not too concerning but what James is showing is a much more complex phobia.  It’s not a simple fear of dogs but a fear of fear from within himself.  The fear is not exclusively being generated by the dog, its being in the vicinity of an uncontrolled animal and what this causes him to feel - ANXIETY.  What his exact fear is I don’t know.  But we can presume its the fear of being bitten and how he might react to this i.e. a full blown panic attack. 

James must tackle his fear using the tools in my program.  But he must get to the core thoughts or thought which is triggering his fears.  Once this is ascertained then he can start building up his confidence by

  1. Just touching the dog
  2. Stroking it
  3. Letting it lick his hands
  4. Then cuddling it
  5. Eventually even taking it for a walk on his own.

All this has to be done with help. Remember if someone is not controlling the dog it can make the anxious person worse.  It’s also best to start with placid small dog before you work up to a Rottweiler. 

As you can see you can overcome panic and agoraphobia but it just takes time and working on your fears to overcome them one by one.

Every tomorrow has two handles. We can take hold of it with the handle of anxiety or the handle of faith.  

Henry Ward Beecher



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