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Panic Attack Isn't Cowardice.

Trauma, Stress, and Fear Trigger Hard-Wired Responses

Trauma, Stress, and Panic continued...

Barlow and Rothbaum both say that this is a normal reaction to an abnormal event.

"Your emotions take over before your brain can react with rational thought," Barlow says. "In cases with a trigger, like this soldier, any time that something occurred that reminded him of it he will relive it and have flashbacks. That is a part of acute stress disorder. It is not uncommon immediately after major trauma if you were not prepared for it: 50% to 60% of the population would have this reaction."

Why do some people get panic attacks and not others? Barlow says we inherit the ways we respond to stress.

"If a person is under stress at work or home, or even under the stress of a positive thing like getting married, panic attacks can happen," he says. "If you have it within you that this is the way you react to stress, you may have one of these false alarms. Others might get irritable bowel syndrome instead. But all of these ways of reacting to stress run in families."

Panic vs. Anxiety

Rothbaum makes a distinction between panic attacks and anxiety attacks.

"A panic attack is very brief. Most people describe it as a wave coming over them," she says. "Most of the time it is over in a minute or two. There are a lot of physical symptoms: You get shortness of breath, lightheaded, dizzy. You feel your heart pounding, you may feel like choking, and there are a number of other unpleasant sensations. Then, afterwards, some people develop the fear of this fear, which can trigger new panic attacks. This is panic disorder."

Unlike panic attacks, anxiety attacks keep on going.

"People can maintain an anxiety attack for a long time," Rothbaum says. "It can have a lot of physical symptoms.

What it all comes down to is the very common -- and sometimes very useful -- human experience of fear.

"We are hard wired for fear. As long as we have been humans, we have experienced fear," Rothbaum says. "It kept our ancestors alive. We don't need it as much in our modern lives, if that system gets fired it feels just like a lion is chasing us. One fear may seem rational and another may be less rational, but both feel the same."

But some people become immobilized when they experience fear. Is that cowardice?

"It has nothing to do with cowardice," Rothbaum says. "I talk about people being brave or courageous when they can do something in the face of fear. But if we can't do something we fear, it is called avoidance. Sometimes a person can't overcome the avoidance. It is very strong in us."

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