The Roots of Panic: Understanding The Factors Behind Panic Attacks

You may already know very well how a panic attack feels. Overwhelming and unstoppable, like a sudden storm sweeping through your body. You may also know that, at its core, it’s your nervous system responding to threats, real or imagined. But why does this happen to some people and not to others? Why does one person shake off stress like leaves in a breeze, while another is overtaken by a surge of fear over a passing thought about leaving the stove on? Like most things in psychology, panic disorder is not the work of a single culprit but rather a tapestry of factors wreathed together. Over the years, different theories have been proposed, each offering a glimpse of the larger picture. Some highlight neurotransmitter imbalances; others point to overactive fear pathways, metabolic sensitivities, or ingrained patterns of thinking. Yet none of these fully explain the deeper question: Panic disorder doesn't seem to carry any good. Why does it exist at all?

Evolution rarely keeps traits around that drain energy without offering some advantage. If panic attacks were merely a flaw, natural selection would have quietly removed them from the gene pool. Yet they remain, affecting countless lives. If panic persists, it must have served a purpose, at least in the past. So, what is happening beneath the surface? We have been exploring this question for decades, examining the roots of panic disorder from every angle. And while we have uncovered valuable clues, the complete picture is still coming into focus. Like a puzzle slowly assembling itself, each piece revealing a bit more of the larger design.

Theories of Panic: From Brain Chemistry to Evolutionary Peculiarities

Over time, different theories have tried to explain why some  minds slip into high alert over seemingly minor stressors. Early models laid the groundwork but didn’t fully explain the emergence of panic. The biochemical theory linked panic attacks to imbalances in neurotransmitters like serotonin and GABA, while the metabolic theory highlighted triggers such as lactic acid, CO2, caffeine, and nicotine. These insights revealed biological sensitivities but didn’t explain why some people are more vulnerable than others [1]. Psychodynamic and cognitive theories explored unconscious conflicts and distorted thought patterns. Later, integrative models knit these perspectives together, emphasizing that panic disorder arises from genetic sensitivities in the nervous system combined with early life stress [2,3]. Although these theories provided valuable insights, they often stopped at highlighting associations, leaving questions about how these factors interweave to create chronic panic episodes. To understand why panic disorder exists at all, we must examine through an evolutionary lens. Anything that doesn’t enhance the survival of your genes tends to fade away. So panic, or panic disorder, must bring something essential to the table.

The first important realization in this context is that panic itself is not a defect. It’s a survival mechanism that, in the right context, protects your life. A racing heart, rapid breath, and heightened alertness may feel overwhelming, but they evolved to keep you connected to the people and resources that ensured your ancestors’ survival. Imagine an infant who senses its caregiver is gone, crying out to call them back. That same system of distress and alarm kept our ancestors safe from the dangers of social isolation. It's a cry for help for others and to others. Therefore, the sensations may rush in when you feel disconnected, even if no immediate threat is present. The flood of sensations you call a panic attack is your body’s way of sounding the alarm: "Call help." In panic disorder this system misfires. Instead of activating only in moments of genuine disconnection or loss, it can be triggered by situations that pose no real danger at all, like a crowded room, a fleeting thought, or sometimes no obvious cause [4]. Why does this happen? Let’s explore.

It often stems from a combination of inherited sensitivities and early experiences. And those experiences don’t need to be dramatic to leave a mark. What matters is how your child self perceived them. A small disappointment, like not getting a lollipop, could have felt earth-shattering at the time. You don’t need to dig up traumatic memories to understand this; it’s about how your young mind interpreted the world. Most importantly, this is a feature, not a flaw. Evolution favored those who overreacted and survived over those who missed real exposure. This "better safe than sorry" design persists because it works. It’s those very genes, carrying a blueprint for a sensitive panic system, that may have helped ensure survival, giving their carriers an edge to escape danger and pass those genes along. If you live with panic disorder, it’s a testament to your body’s ancient survival blueprint, a system that’s simply trying a little too hard [4].

Panic Disorder and the Fear of Disconnection: The Missing Link

So, what is this panic system working so hard to protect you from? Panic disorder is often linked to fear of external threats, but a closer look at the mind’s patterns reveals a deeper layer. Panic isn’t just about the shadowy figure in the alley or the cyclist that appears out of nowhere; it’s about facing threats alone. Humans are deeply social creatures, evolved to flourish within groups. Connection offers safety, resources, and shared protection. Isolation, however, magnifies vulnerability, making the fear of separation deeply embedded in your biology. In panic disorder, this fear of loss, of connection, security, or belonging, takes center stage. Panic doesn’t just ignite the general FEAR web; it foremost activates the separation distress emotions: the PANIC/GRIEF network. This system drives the intense emotional reaction tied to feelings of abandonment or isolation. It’s not about the fear of a particular threat, but the overwhelming sense of facing the world without support [5].

This underlying fear of separation explains why panic disorder often emerges during major life transitions or losses, like moving to a new place, losing a loved one, or facing significant changes. These experiences can leave you feeling adrift, increasing your vulnerability to panic. Early life experiences also matter. Childhood separation anxiety, emotional neglect, or feelings of loneliness can affect the development of your emotional regulation, leaving you less equipped to manage distress later in life. Panic disorder often reflects unacknowledged feelings of isolation and unmet needs for connection. But it’s not the events themselves that matter most, it’s your experience of them. The same situation can leave a lasting impact on one person but be a passing memory for another. For instance, getting lost in a grocery store as a child might be a minor story for one person but a lasting source of vulnerability for another [5].

Panic Disorder: Learning to Recalibrate

Panic attacks can be devastating, shaking the ground beneath your feet and leaving a deep imprint on your quality of life. Yet panic disorder is highly treatable, and behavioral approaches consistently bring about positive outcomes. Your mind’s timeworn alarm system evolved to protect you, even if it sometimes overreacts to modern challenges. But with steady practice and the right tools, you can help it find a calmer rhythm. Emotional helath isn’t about silencing every note or achieving constant peace, life is more dynamic than that. It’s about learning to steady yourself when the tempo quickens, and finding moments of grace even in the most discordant passages. Whether you chose grounding techniques, recalibrating your inner responses, or reshaping old emotional patterns, every step strengthens your capacity to meet the challange with more composure.

Panic may be part of your composition, but it doesn’t have to define your entire  life. The rest of the way forward is yours to choose. Emotional health is your steady companion on this path, a practice of learning to hear the notes of your own mind and guide them toward harmony. Like a traveler learning to navigate winding paths and shifting landscapes, you can learn to work with your system, one step, one landmark, one steady breath at a time.

[1] Ankrom, S. (2019). Biological theories of panic disorder. https://www.verywellmind.com/biological-theories-of-panic-disorder-2583924.
[2] Fava, L., & Morton, J. (2009). Causal modeling of panic disorder theories. Clinical psychology review, 29(7), 623-637.
[3] Fava, L., & Morton, J. (2009). Causal modeling of panic disorder theories. Clinical psychology review, 29(7), 623-637.
[4] Nesse, R. M. (1987). An evolutionary perspective on panic disorder and agoraphobia. Ethology and Sociobiology, 8(1), 73-83.
[5] Francesetti, G., Alcaro, A., & Settanni, M. (2020). Panic disorder: attack of fear or acute attack of solitude? Convergences between affective neuroscience and phenomenological-Gestalt perspective. Research in Psychotherapy: Psychopathology, Process, and Outcome, 23(1), 77-87. https://doi.org/10.4081/ripppo.2020.421