Panic Attacks, The Amygdala, The Prefrontal Cortex, and an Elevator

If you’ve followed my writing you’ll know I believe misinterpretation and overreaction are the number one psychological contributors to panic attacks. I believe so deeply in this truth that I coined the term, “interpreaction,” to underscore the power of the relationship between interpretation and reaction. Well, let’s take a look at this concept within the context of a very real life scenario.

A few days ago I summoned an elevator to the 11th floor of a building. As I waited, a massive floor to ceiling window caught my attention and I very comfortably gazed outside absorbing the landscape. And suddenly I said to myself, “You know, this is really very fascinating. Here I stand within 24 inches of a 110 foot fall to a very messy death, the only thing standing in the way being a one-quarter-inch thick piece of glass (and my desire to stay alive), and it doesn’t bother me!” And, then, the realization hit home that if that piece of glass wasn’t there I’d be frozen solid in fear. So, on one set I’m fine and on the other I’m terrified and immobile. And the only difference is a one-quarter-inch thick glass prop.

As I’ve ruminated over the matter I’ve been terribly annoyed by the injustice and indignation of a one-quarter-inch thick piece of glass holding such power over my emotions, thought, and behavior. And it’s this kind of spunk and drive, along with the incredible power of reason, that hold the very keys to overcoming panic attacks, simple phobias, and any number of anxiety’s manifestations. No doubt, the very bottom-line fact is, logically my potential for catastrophe was virtually non-existent whether or not the glass was there. And if I truly receive and digest that message I must believe I possess what it takes to overcome my compromised reasoning, leading to absolutely no fear should I choose to stand unshielded within two feet of the edge of a building’s 11th floor. Doesn’t that make sense?

Well, back to that 11th floor. Let’s take a look at an edited script. There I was enjoying a beautiful view through this massive floor to ceiling window as I waited for the elevator. All was well with the world until out of nowhere the window was gone, leaving nothing but open air. And there I stood within two feet of that very messy catastrophe I’d considered when I knew I was safe and sound. Reading the new script, here are the biochemical events that would be going down in my mind.

My brain’s sensation receiving hub, the thalamus, is soaking up signals from my sense of sight that the glass is gone. It’s receiving the word from my sense of hearing that the wind’s blowing and there’s road noise below. And it’s receiving a signal from my sense of touch that the wind’s blowing against my skin. Well, after receiving these messages my thalamus begins to send information to other components of my brain. One message is headed toward my amygdala and the other is on the way to my prefrontal cortex. But, it’s important to note the message to my amygdala is the more expedient of the two.

When my amygdala receives its message it sounds the alarm because it’s not interested in interpretation. Its job is to fire and entertain questions later. As a result, my HPA axis gets cranked up, and that leads to the secretion of cortisol, norepinephrine, and epinephrine. So now my fight/flight response is chugging along like a locomotive. Oh, and my amygdala is also sending a message to my brainstem to facilitate additional adjustments to heart rate and respiration.

Well, the slower message finally arrives at my prefrontal cortex and it’s time for some reasoned interpretation and decision making. And after a lightening quick analysis it sends a message back to the amygdala to continue firing because this is definitely a life threatening event. And with that, my fight/flight locomotive chugs on and if I can manage to thaw from my full body freeze, I’m out of there!

But, wait, a true danger didn’t exist. Remember? We’ve already established I was safe whether or not the glass was in place. That being the case, my prefrontal cortex misinterpreted the signals from my amygdala, resulting in a perceived threat. Within this context, the events could have gone down very differently. Had my amygdala received a message from my prefrontal cortex that, indeed, no true danger existed it would have turned off the alarms and in short order calm would have been restored. And I’d have stood there facing the breeze from 110 feet up without batting an eye.

To me, what I’m presenting is very logical and theoretically correct. And I believe striving for this kind of reason is foundational in resolving our irrational fears. However, thought alone isn’t going to get the job done. No, facilitating management over our myth-generating reasoning takes practice. And with sufficient amounts of motivation and effort we can make great strides toward holding our fears, anxiety, and panic in check.

As you consider these dynamics, go back to my 11th floor scenario and remind yourself that with the exception of a silly one-quarter-inch thick piece of glass, nothing on the two sets was different. And that includes a poorly disciplined prefrontal cortex that allowed misinterpretation to run wild.