What Donguibogam calls palpitations due to fright shares many similarities with what we refer to today as a panic attack. A panic attack refers to a state where an abrupt wave of intense fear strikes alongside physical symptoms that make one feel as though their heart might stop or they might die. Beyond a simple feeling of anxiety, it is a phenomenon in which the brain and body sound an excessive emergency alarm in an unpredictable situation.
At the center of this phenomenon lies a region of the brain called the amygdala. The amygdala acts like the brain's alarm system, detecting threats and processing fear responses. Under normal circumstances, it plays an essential role in survival, but during a panic attack, this amygdala becomes excessively activated even by trivial stimuli or when there is no actual threat, much like a malfunctioning fire alarm.
When the amygdala is activated, the hypothalamic-pituitary-adrenal axis, which oversees the fight-or-flight response, receives stimulation. This axis prompts the secretion of stress hormones such as cortisol and catecholamines like epinephrine. These hormones sharply increase the heartbeat rate, elevate blood pressure, and make breathing rapid. The body mobilizes every emergency system as though facing immense danger right at that second. These physiological changes are precisely what we perceive as severe palpitations and suffocation.
At the same time, the autonomic nervous system is heavily impacted. The autonomic nervous system regulates life-sustaining functions such as heartbeat, breathing, and digestion independently of our conscious will. During a panic attack, the sympathetic nervous system becomes excessively activated, and the regulatory function of the parasympathetic nervous system weakens. If the sympathetic nerve is like pressing the accelerator and the parasympathetic nerve is like pressing the brake, a panic attack is a state where only the accelerator is held down. This imbalance manifests as diverse physical symptoms, including increased sweating, numbness in the hands and feet, and dizziness, driving the brain and body into a vicious cycle of exchanging danger signals.
Ultimately, a panic attack is not merely a psychological issue; it is a physical and mental emergency produced by the complex interactions of brain structure, function, and the neuroendocrine system. Just as Donguibogam read the state of the mind and body through changes in the pulse, modern medicine also analyzes these complex bodily reactions from neurological and endocrinological perspectives, listening attentively to our body's cries.
