The Fight or Flight Theory of Panic Disorder

What Is the Fight or Flight Response and How Is It Related to Panic Disorder?

The fight-or-flight response is a stress reaction that likely evolved out of the survival needs of our early ancestors living with the daily dangers of the time. To demonstrate, imagine you’re a prehistoric cave dweller relaxing one evening and enjoying the daily catch. Suddenly, a large and hungry saber-toothed tiger appears on your doorstep. To him you look like a tasty morsel on the food chain.

But, human design kicks in with a surge of strength and energy, increasing your chances of surviving this encounter.

Some theorists believe that this old stress reaction is seen in the common fears associated with modern day panic disorder. Specifically, in the fear of large open spaces or being in situations without an easy escape route. In the dangerous world of our ancestors, crossing a large open field leaves one vulnerable to attack. The same can be said for being cornered without any means of escape.

What Happens When the Fight-or-Flight Response Is Triggered?

Researchers have identified numerous physiological changes that occur during the flight-or-flight stress response. These changes are believed to be triggered by the sympathetic nervous system through the release of stress hormones, such as, epinephrine (adrenaline) into the blood stream. This release causes immediate physical reactions in preparation of the muscular activity needed to fight or flee the threat.

Some of the changes during this process include:

  • Increased heart rate
  • Accelerated breathing
  • Constriction of blood vessels to some parts of the body and dilation of blood vessels to the muscles
  • Dilation of pupils
  • Auditory Exclusion (hearing loss)
  • Tunnel Vision (loss of peripheral vision)
  • Sweating to cool your body in response to the heat generated as your body gets ready to contend with a predator

    These physical changes occur rapidly and automatically. If one were experiencing a life-threatening event, they would be expected. But, when they occur while picking up a few groceries for dinner or sitting in a meeting at work, they can be quite frightening.

    How Fear Is Reinforced When There Is No Danger

    During a panic attack, the body’s alarm system is triggered without the presence of any danger. It is the absence of identifiable danger that actually intensifies the fear associated with panic attacks. If there is an identifiable danger, we understand the symptoms. We can then fear the danger, not the symptoms. However, if there is no danger and someone experiences sweating and changes in heart rate, breathing, vision, and hearing, it would seem logical to fear the symptoms, even believing they are life-threatening.

    Physically, your body is telling you to get ready, you are in grave danger. But how do you prepare psychologically for certain danger that is unseen? It may be that you assign the symptoms mistaken meaning.

    It may be that you immediately flee the situation as if it were dangerous. But, these thoughts and actions don’t get you out of danger. They only reinforce and strengthen the association of a fear that is not based on an actual threat.


    Carbonell, D. "Panic Attacks Workbook" 2004 Berkley, CA: Ulysses Press.

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