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Panic Can Build Gradually from Chronic Stress

Panic May Result from Chronic StressNew research has surprising findings that may help people with panic disorder more successfully manage the condition.

Scientists discovered that panic attacks may not be a reaction to an acute event, but instead the result of gradual and steady accumulation of stress over a period of weeks.

Researchers from Brown University wanted to study how daily stress — such as fighting with a partner — affects an individual’s panic symptoms. Their findings are counterintuitive as they discovered some kinds of stressful life events cause panic symptoms to increase gradually over succeeding months, rather than to spike immediately.

“We definitely expected the symptoms to get worse over time, but we also thought the symptoms would get worse right away,” said Ethan Moitra, a postdoctoral researcher at the Warren Alpert Medical School of Brown University.

But even if the events don’t seem to trigger an immediate panic attack, said Dr. Martin Keller, principal investigator of the research, patients, family members, or their psychiatrists need to keep their guard up.

“If they have the event and they are not feeling much different then maybe the vigilance on the individual’s part decreases somewhat,” Keller said. “With the knowledge we have, you may need to stay vigilant for three months or maybe longer. This is something you have to watch for.”

In their study, lead author Moitra, Keller, and their co-authors also found that panic symptoms did not seem to increase in advance of stressful life events, even if they were predictable, such as a divorce becoming official.

The research is based on annual assessments of 418 adults with panic disorder or panic disorder with agoraphobia, who were enrolled in the Harvard/Brown Anxiety Research Project (HARP) between 1998 and 2004.

Research staff asked the volunteers detailed, standardized questions about important events in their lives and their levels of anxiety. The findings are published in the Journal of Affective Disorders.

The study found that for stressful life events in the categories of “work,” such as a demotion or layoff, or “friends/family/household,” such as a family argument, panic symptoms that had meandering severity before the event increased steadily but gradually for at least 12 weeks afterward.

While the findings about the effect of some stressful life events on symptoms of people already diagnosed with panic disorder are new, other researchers have connected stress to panic attacks before.

Stressful events are associated with the onset of panic disorder in the vast majority of cases, Moitra said. In these cases, people with panic disorder may anticipate bouts of hyperventilation, which in turn can lead to panic responses.

Nevertheless, while some stressful events have proven to be associated with changes in panic symptom levels, additional research is needed to understand the role of stressful events.

“This may be one of those reasons why panic disorders can get worse,” Moitra said.

Source: Brown University

Panic Can Build Gradually from Chronic Stress

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Panic Can Build Gradually from Chronic Stress. Psych Central. Retrieved on December 5, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 21 Jun 2011)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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