While Donguibogam speaks of the agitation of the spirit, modern medicine explains this through complex interactions between the brain and the nervous system. Panic disorder is a type of anxiety disorder characterized by sudden and intense fear accompanied by diverse physical symptoms. This can be viewed as a phenomenon occurring when our brain's alarm system malfunctions.
At the core of this alarm system lies the amygdala. The amygdala detects threats and generates fear responses, but in individuals with panic disorder, this amygdala tends to react with abnormal hypersensitivity. Even in non-threatening situations, the amygdala sounds an alarm that something terrible has happened, instantly activating our body's sympathetic nervous system. When the sympathetic nervous system is activated, the fight-or-flight response is triggered, producing physical changes such as rapid palpitations, hyperventilation, elevated blood pressure, and full-body muscle tension. At this time, stress hormones such as adrenaline and noradrenaline are rapidly secreted, amplifying these reactions even further.
Furthermore, the prefrontal cortex functions to suppress excessive reactions of the amygdala and make rational judgments, yet in patients with panic disorder, a decline in prefrontal cortex function is often observed, leaving it unable to prevent the amygdala from running wild. This imbalance in brain function can arise from a combination of diverse causes, including genetic factors, developmental environment, stress, and the use of certain medications.
The physical symptoms during a panic attack feel so real that many people mistake them for actual physical illnesses such as a heart attack or asphyxia. Chest pain, feelings of choking, dizziness, numbness in hands and feet, sweating, trembling, and derealization are common, all of which are emergency signals that the brain is sending to our body. When these experiences recur, anticipatory anxiety, the fear that another attack might occur, develops, causing severe difficulties in daily life. Panic disorder is never caused by personal weakness, but is a real illness accompanied by biological changes in brain function. Understanding, warm care, and proper treatment are essential.
