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When the wiring goes awry

Psychologist Carolyn Neunuebel explains why panic attacks occur

A panic attack means the sympathetic nervous system has been activated for the fight or flight mechanism. This was useful when humans were under attack - from a wild beast, for example. It responds dramatically to the concept of danger.

But when someone is having a panic attack, the danger isn't real. Even so, the body still goes into that state. With modern problems, 'fight or flight' doesn't work as it was intended. It's only useful in that you're pumping more blood and you can, therefore, run further. That's why people having panic attacks have hot flushes.

For the person having the attack, it feels as if they're going crazy or they're dying. Obsessive compulsive disorder sufferers may worry about contamination from dirt or harming someone, and also may perform rituals, such as repetitive counting or checking that a kettle has been switched off. These can become so severe they affect the person's ability to work or maintain relationships.

Cognitive behavioural therapy can be effective. It has to do with changing the way you think and the way you respond to an anxious situation. A lot of our thinking creates anxiety. For example worrying that you'll be fired because you're running late for work. It can be what's called catastrophising. This kind of thought operates in childhood, because you have no power over your environment and you can't change things. But as an adult, you're in control.

People can teach themselves by writing down their negative thoughts and replacing them with something more rational. On the behavioural side, someone who has social anxiety, for example, could go to a cocktail party and stay for 15 minutes. Then, they could evaluate it. This helps them do what they fear with the right set of thinking patterns.'

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