People with panic disorder often misinterpret the symptoms of anxiety and panic as signs that something serious is wrong with them. It is understandable that, in the absence of clear explanations for the symptoms, people believe that they have a serious physical or mental problem. As a result of this misinterpretation, however, the symptoms themselves are seen as threatening, and can trigger the anxiety response.
There are a number of typical fears about anxiety symptoms which people with panic disorder have.
Many people believe that their panic symptoms indicate they are having a heart attack. This belief arises from the assumption that the symptoms of breathlessness and chest pain are the same as those that occur during a heart attack. Most people have never had a heart attack, and hence are not aware of the differences in symptoms between a heart attack and a panic attack. Dull, central chest pain radiating to the left shoulder, arm or jaw, is a typical sign of a heart attack. The pain associated with a heart attack is not made worse by overbreathing, which is in contrast to the symptoms of panic. The symptoms of heart disease are generally related to effort, and reduce at rest. This is in contrast to panic attacks which can occur during exercise, but also happen at other times. Finally, heart disease produces changes in the electrical activity of the heart, which are not produced during a panic attack.
Fainting or collapsing
Other people believe that as a result of their panic symptoms such as dizziness and lightheadedness, they will faint or collapse. The anxiety response actually involves an increase in blood pressure, so it very unlikely that fainting, which involves a drop in blood pressure, will occur. Consider that a fight or flight response designed to protect an individual from harm would not be very useful if it involved collapsing at the first sign of danger.
Another common belief is the fear of doing something "wild" or strange as a result of panic. This assumption seems to arise from people's experience of feeling overwhelmed by panic. During the fight or flight response, the whole body is on alert, preparing to deal with the threat and there is often a great urge to flee the source of danger. This is an adaptive function of the fight or flight response. Symptoms of "confusion" and feelings of unreality can be a result of your mind being focused on the perceived source of danger (the anxiety symptoms themselves). Overbreathing can also contribute to these sensations. Consider that even though you may feel "out of control", you still decide what action to take in response to panic, ie. whether to stay or leave.
Some people believe that the panic symptoms mean that they are going mad or crazy. Not knowing what is happening to you can be very frightening, particularly when the symptoms are occurring frequently. While the symptoms of the fight or flight response may have been interpreted as strange, however, particularly when no obvious explanation for them has existed, these symptoms are very different from those of a severe mental disorder like schizophrenia. Schizophrenia is characterised by thought disorder and delusions and/or hallucinations. Schizophrenia runs strongly in families; only a certain number of people have the vulnerability towards developing the condition, and in other people no amount of stress will precipitate the disorder.
Other common fears that people with panic disorder report include having a stroke, having a brain tumour, stopping breathing, or dying. It is easy to see how these beliefs about panic symptoms can maintain and exacerbate your symptoms. If someone believes that they may stop breathing when they panic, then the experience of panic is understandably very frightening. The person constantly worries about panic occurring, and attempts to avoid it at all costs because of what they fear may happen. Learning to challenge these false beliefs about the symptoms of panic is an important part of treatment.