Panic Attack Contributors (Yikes!) | Lest We Forget Hyperventilation and That Danged Suffocation Alarm

“These panic attack symptoms are zoomin’ out of control, Mr. Bill. I’m sick and tired of anxiety disorders. Come on now, someone’s gotta’ help me make some sense of this. What’s behind it all? Something? Anything?”

Okay, surely you know by now that nailing-down for-sure mood and anxiety disorder causes – contributors – can be a dicey proposition. Panic attacks present that very dilemma; however, there’s some finger-pointing going-on – and here’s an interactive biggie…

Panic Attack Symptoms in the Lab

Bunches of what’s known about the biology of panic comes from laboratory provocation studies. Yep, scientists induce panic attacks through the administration of panic-inducing substances. The most common “panicogenics” used are sodium lactate (a natural salt derived from lactic acid), carbon dioxide, caffeine, and yohimbine.

These panicogenics do the job, and it’s interesting that for whatever reason the introduction of sodium lactate generates panic only in panic-diagnosed subjects.

Panic Attack Symptoms & Hyperventilation

Hyperventilation is a huge panic consideration. During hyperventilation a significant imbalance occurs between carbon dioxide (exhaled) and oxygen (inhaled), resulting in unusually low blood levels of carbon dioxide. The body’s efforts to correct the rate and balance of respiration causes panic-scary symptoms (jelly-legs, “lightheadedness,” tingling in the extremities, brown bag over nose and mouth?, etc.).

Fact is, hyperventilation leads to a build-up of lactic acid, which we just learned generates panic attacks. And, of course, the more we misinterpret and overact to the symptoms of hyperventilation, the more unbalanced our breathing becomes – which generates more symptoms. And everything very quickly snowballs out of control. Boom!

All of this hub-bub has many scientists arguing that panic sufferers are actually chronic “hyperventilators,” who seriously sabotage their breathing effort – breathing themselves into trouble during times of stress and anxiety.

Panic Attack Symptoms | Suffocation Monitor and Alarm

In 1993 Dr. D.F. Klein came up with the idea that panic attacks may be generated by a false suffocation alarm. Wha? Well, according to Klein this mechanism detects high levels of carbon dioxide, which may exist as a result of a potentially low supply of oxygen. (Hey, didn’t we just discuss carbon dioxide being used in the lab to trigger panic attacks?!)

So, yes, when high levels of carbon dioxide are detected the brain triggers a suffocation alarm indicating the amount of useful air is getting low. The body then goes into reparative-action to correct a perceived chemical imbalance, saving the body from suffocation. Only problem is, some of the physical responses generated by this reparative-action can be misinterpreted as panic – and the snowball continues to roll downhill.

The results of a brand-spankin’-new study published in Biological Psychiatry give us more insight into this suffocation alarm biz. The lead authors are Dr. Jordan W. Smoller (Professor of Psychiatry at Harvard Medical School and Massachusetts General Hospital) and Dr. Bruce M. Cohen (Professor of Psychiatry at Harvard Medical School).

Seems previous research in mice showed the protein ASIC1a indirectly acts as a carbon dioxide sensor in the amygdala, a brain region huge in the perception of danger and fear – panic (red in the image). Well, an international team of scientists led by Smoller and Cohen have studied the human version of the ASIC1a gene, ACCN2  – and have come up with some cool findings.

The team sliced-and-diced ACCN2 variants in 414 folks with panic and 846 without. In a separate group of non-panics, the team examined potential genetic associations with amygdala volume and function in some 1200 subjects. Here’s Smoller on the findings…

We found that different forms or variants of the human ASIC1a gene appear to be associated with panic disorder. The effect was stronger in those whose panic attacks have prominent respiratory symptoms, including shortness of breath and feelings of suffocation.

Next, we found that the panic-associated variants in the ASIC1a gene are also associated with both the size of the amygdala and a greater amygdala response to emotional threat, even in people without panic disorder.

What’s that supposed to mean? According to Cohen…

Taken together, our results suggest that the (human) ASIC1a gene is a risk gene for panic disorder, as well as for the structure and function of the amygdala and its reaction to threat. They also raise the possibility that drugs that inhibit or modulate ASIC1a might be helpful in the treatment of panic or other forms of anxiety and fear.

So what do you think? I’m thinking this suffocation monitor and alarm chit-chat is the real deal.

That’s All, Folks!

I just love this stuff! I mean, it’s insight such as this that gave me so much hope when I was lost in the woods with panic attack symptoms and other anxiety disorders all those years ago.

And that’s what I want for you – the hope that comes from serious research, practical applications, and gaining insight into what goes on in that noggin of yours. So there…

Savy?

Hey, tip of the hat to Elsevier for the research scoop.

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