Panic Attack Warning Signs

by Jerry Kennard, Ph.D. Medical Reviewer

One of the most distressing features of a panic attack is the way they affect people out of the blue - or do they? Alicia E. Meuret, assistant professor of psychology at Southern Methodist University and colleagues, have discovered that a number of subtle but important changes occur in the body up to an hour before the onset of an attack. The problem for people prone to panic is they remain completely unaware of what is happening.

During the study, volunteers who experience panic attacks were asked to wear 24-hour portable recording devices that monitored a variety of physical responses. Possibly one of the most significant issues to arise was that levels of carbon dioxide were seen to be abnormally low and indicated chronic hyperventilation. These levels then rose significantly just before the panic attack. High levels of carbon dioxide in the body do cause sensations associated with suffocation and this can trigger panic.

Given the fact that most symptoms relating to panic attacks are physiological it's hardly surprising to find that people think they are experiencing some severe physical ailment like a heart attack. As Meuret points out, only three of the 13 symptoms associated with panic are psychological in nature: feelings of unreality, fear of losing control and fear of dying.

The hope is that these findings might open new avenues of investigation into why these physiological changes are happening and in turn provide treatments. As the authors say, the challenge for psychological therapies such as cognitive behavioral therapy (CBT) is that the patient needs to examine their thoughts in order to prevent an attack. In the case of unexpected panic a patient can't prepare themselves if they are completely unaware of the processes leading up to the attack.


Do Unexpected Panic Attacks Occur Spontaneously?
Alicia E. Meuret, David Rosenfield, Frank H. Wilhelm, Enlu Zhou, Ansgar Conrad, Thomas Ritz, Walton T. Roth. Biological Psychiatry, 23 July 2011

Jerry Kennard, Ph.D.
Meet Our Writer
Jerry Kennard, Ph.D.

Jerry Kennard, Ph.D., is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry’s work background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of