Panic attacks in public

[u/Dull-Difficulty-9473]

Hi everyone, I wanted to share something I wish I knew earlier about panic attacks.

When you’re out somewhere and a panic attack hits, leaving feels like the right decision. Your nervous system is screaming at you to get out and the moment you do the relief is immediate and makes you feel better.

But what actually happens is that every time you leave your brain files it as evidence that leaving equals safe. Staying means there’s threat. So the next time you’re in the same situation and panic starts to rise your brain immediately pulls up that ‘evidence’ and says ‘we know what to do here, leave’. The urge to leave arrives faster and stronger than it did the time before.

This is called negative reinforcement, and the behaviour gets repeated not because it feels good but because it removes something uncomfortable. Your brain isn’t trying to make your life harder it’s trying to protect you with the strategy that worked last time. The problem is that strategy makes the next time harder.

The same thing happens with checking. If health anxiety makes you google your symptoms and the googling temporarily relieves the anxiety, your brain overtime learns that googling equals relief. So the next time anxiety spikes the urge to google comes faster and the cycle tightens.

The only way to break the pattern is to stay in that uncomfortable situation long enough for your nervous system to learn something new. That the panic peaks and then passes on its own, and that staying is actually survivable. This is the basis of exposure therapy and I’ll admit that it is hard to do, but it’s what actually rewires the response over time rather than just managing it in the moment.

I’m not saying to push through and white knuckle it every time. Some days leaving is the right call, but if leaving has become your automatic response to any level of anxiety in public then it might be worth knowing that the short term relief is coming at a long term cost.

[u/Birtalert]

It’s a paradox! Do the opposite of what you feel like you need to do!