For those that suffer with them, panic attacks are among the scariest, most inexplicable things out there. They can seem to strike at any time and often leave the sufferer unable to communicate or even function properly. While the specific real-world triggers and the symptoms of panic attacks can vary from person to person—fast breathing, perspiration, intense dread, rapid heartbeat and chest pain, among others—the neurochemical reactions behind them are generally pretty similar across the board.

Do you know what’s behind your panic attacks?

Fight or Flight and the Autonomic Nervous System

When your brain perceives a threat—a wild animal, for example—your Autonomic Nervous System (ANS) jumps into action. This system in your body is split into two sections, the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). Initially, it’s the SNS that reacts, releasing a cocktail of powerful neurochemicals into your body: epinephrine (also known as adrenaline) and cortisol. To aid you in either escaping or fighting the threat, these chemicals cause your heart to race, your skin to sweat, your digestive system to slow significantly and your brain to work on overdrive. (Do these sound familiar?)

When you’ve escaped or fought off the threat, the PNS starts to work reversing the effects of the SNS. Your heart rate will slow, you’ll start to calm down and you can breathe a big, gentle sigh of relief.

Now, what does that have to do with a panic attack?

The Malfunctioning Autonomic Nervous System

When it’s working properly, the ANS kicks into gear when there’s a short-term, tangible threat. When it’s not working properly, it’s liable to start releasing adrenaline and cortisol, triggering the ‘fight or flight’ response, when there’s no threat at all. This, as you may have guessed, is what causes panic attacks. It’s the brain reacting to nothing (or at least nothing that’s actually dangerous) as if it were life-threatening. So, when you’re full of dread, struggling to breathe with a pounding heart, your body is genuinely reacting as if it were in a life-and-death situation.

Long-Term Impact

What’s worse, due to panic attacks being a result of the ANS ‘imagining’ threats, the body can’t tell when the (non-existent) threat has subsided. This means that people suffering from anxiety are likely to live with chronically high levels of epinephrine and cortisol in their bodies. This long-term stress takes a serious toll on the body: it can lead to a number of serious health complications and weaken the immune system.

Panic Attacks aren’t to be taken lightly. For onlookers, it might look as if an attack is just someone ‘jumping at shadows’, but it’s incredibly real and traumatic for the person experiencing it. If you’re dealing with panic attacks, remember, it’s not “all in your head”. A panic attack is a physical, neurochemical reaction to a perceived life-threatening event. Whether that threat exists or not is irrelevant: it feels real, therefore it matters.