The Process to Panic - Neuroscience of Panic

Hey there. This is Dr. Nicole, and I want to show you a drawing that I made that walks you through what's happening in the brain when we go into a state of panic. And so you're going to see me here now, and then the camera is going to switch, and I'm going to teach you about the process to panic. And so if you have questions about this, just. Just let me know by leaving a comment and I'll do my best to answer your questions at the end. If we don't get to the answers to your questions, then I'll be sure to save this video and the comments don't actually transfer over. And so if I don't answer your question, then just leave a comment on the downloaded video or send us a DM and we'll do my best to answer every single comment or question. Let's learn about the process to panic. And so here you have a picture of a brain that I drew. And so if you're looking at it, the orientation is if you're looking at someone's left side and you're looking at as though their nose is over here. And so this is the prefrontal cortex. This is the cortex around the top of the brain. And then you have your occiput, your cerebellum, and your brain stem. And so oftentimes when we have a panic attack, it can be incredibly overwhelming. And a lot of people ask me if the different feelings that they're experiencing are normal and they want to know why it's happening. And so understanding brain science, understanding what's happening in your brain and your body can really help create a sense of control and a sense of agency when our symptoms are rising. And by starting knowing what's going on during panic, it gives us tools to actually stop the panic. It gives us tools to heal. And so let's walk through this diagram together. And so when we start, we want to think about the thalamus. And so the thalamus is number one here. And this is a part of the brain that is kind of like the post office of the brain. It gets information in from sensory input, so vision and hearing and different things like touch and kinesthetic or tactile information, they all enter the brain into the thalamus. And then the job of the thalamus is to try to detect if this information that's coming in is relevant or if we can ignore it. So an example is if you're sitting at a coffee shop and there's lots of noise going on around you, but you're trying to focus on reading a book. Your thalamus is trying to decode if it should be paid attention to or if something can be ignored. And so, ideally, you can focus and you can listen to your audiobook or you can do some work, whatever that is. And so when the thalamus gets information and it decides it's relevant, it sends that information to two parts of the brain, which we have depicted with these gold stars. The first part of the brain is the frontal lobe, which is here towards your forehead. And then the second part of the brain is the amygdala, which is. Which is right around here. And so information travels much more slowly to the frontal lobe. So we're going to do that one second. But when the thalamus decides that input is relevant, it's going to very quickly go to your amygdala. Your amygdala is the part of the brain that's responsible for emotions. It's part of your unconscious brain. And it helps with fear, it helps with love, it helps with joy. Joy. It helps with anger. Your amygdala is the seat of emotions, and it's creating these emotions based on the information that it's getting from other parts of your brain and your body. And so when the thalamus sends information onto your amygdala, the amygdala recruits help from the hippocampus and the cingulate gyrus, primarily in order to decide what this input means to us. Is it good? Is it bad? Is it dangerous? And so the hippocampus joins this conversation by reminding us about events from the past. The job of the hippocampus is to remember when something happens. It categorizes that event and it logs it away so that it can reference that and use it to give you context in your current life. And then your cingulate gyrus has an incredible emotional processing power. And so it jumps in to assist the amygdala. And so the amygdala decides what to do. So let's say that the amygdala has decided that danger is afoot. If danger is afoot, the amygdala will recruit help from your body. It will recruit the hypothalamus, and it will activate your brain stem. So your hypothalamus is here, and this is your brain stem. And so if the amygdala decides that there's danger, then it will ask the hypothalamus in the brainstem to change, jump in, and offer assistance. And so what will happen? Next is that your body will respond in sending stress hormones to your body, primarily adrenaline and cortisol. Adrenaline is that fight, flight, freeze feeling where our blood pressure spikes and our heart rate speeds up and we get really restless and our body temperature goes up. And cortisol, it's our primary stress hormone released by the adrenal glands, adds to this. The whole point of the stress hormone release is to prepare your body to fight flight or freeze. And so there's many symptoms that occur as a result of these hormonal changes. So your heart rate is increasing because your heart's delivering blood to your body so that you can run away or fight. Your breathing increases, but you might notice that it's quite shallow. And that's why sometimes when we're feeling panicky and anxious, our heart is pounding, but we feel like we can't catch our breath. You might also notice your body temperature rising, and that's because of all the increased metabolic activity. You might also notice that it's hard to feel your fingertips. Maybe you find that they're numb or tingly. Sometimes people tell me about numbness and tingling that can happen in other parts of their body. Like half of your face goes numb or it's hard to move your fine motors. And that's because your body is dedicating all of its energy to help you escape. So what's really interesting is that when the amygdala is convinced that there's extreme danger, it can actually shut down your frontal lobe, which, by the way, has slowly gotten the information from your thalamus, right? So remember, it goes to the amygdala faster and then the signal can get to the frontal lobe more slowly, your frontal lobe here by the forehead. Its job is to help you put logic on what's going on. So let's use an example. So let's say that we have a military vet, and the military vet has been in active combat. And the brain of that vet, the hippocampus, remembers, the brain of that vet has learned that the sound of explosions is dangerous, it's life threatening. And so the hippocampus, the brain has logged away that those kinds of sounds are very dangerous. So let's say that they are back in civilian life and they hear the sound of a car backfiring. The thalamus takes that hearing, it takes that input, it sends it to the amygdala. The amygdala recruits help from the hippocampus and the cingulate gyrus. And they all determine together that there's Danger. And so even before the veteran can discern that the frontal lobe, with the frontal lobe that, oh, it's a car backfiring and I'm safe. Before this can even kick in and happen, we've already gone into fight, flight, freeze. And that's why we can feel really anxious and panicky, even when it's not logical. And so what can happen is that the frontal lobe can eventually kick in and we can talk ourselves down from panic, we can talk ourselves out of fear. But like I was hinting at earlier, if that amygdala signal is so strong, strong that it's overriding the rest of the brain, is we can actually find that people can't use their frontal lobes. In fact, the work of lots of neuroscientists, Bessel van der Kolk and Bruce Perry and many other neuroscientists have found that when we look at functional MRI scans of people who have complex trauma, that when they're in a trauma activation, there's actually very little activity in the frontal lobe, particularly the medial prefrontal cortex, the part of the brain that's responsible for emotional processing, logic, reasoning. And so that's why it can feel so unlogical. To feel anxious and to have a panic attack is because we don't actually have access to that part of the brain. So today we've been talking about the process to panic, and we've been learning about what's actually happening when we get information and our body panics about it. And sometimes our body can get stuck in this panic groove where we feel like we can't get out, and it feels unlogical and it feels annoying and irritating. And there are ways to actually help correct that. And by knowing what's happening in the brain, it gives us tools on what to do about it. And so I'm Dr. Nicole, and I'm here to teach you all about your brain. I'm here to teach you about why you feel the way you feel, so that you have the tools to actually heal. And so I'll be coming back and we'll be talking about a three prong approach for actually helping the brain to no longer need to go into panic. And this three prong approach is incredibly effective. And it's based in neuroscience, it's trauma informed, and it really works. And so make sure that if you haven't give this page a follow, like the video, and then if you have any questions, just send them over. And if I don't get to them during this live video, then just let me know and Send me a DM and I'll be sure to answer a question. One of the questions that I did get asked, that I saw show up here in the comments is what happens if the panic feels like it's going to be really dangerous? Can panic actually hurt me? The answer to that question is that when your body is producing adrenaline and cortisol and it's part of the natural process, your body is designed to do that. And your panic isn't dangerous, your anxiety isn't harmful. And so the most important thing to do is to know, is to identify and acknowledge. Okay, my body is amplified right now. I'm noticing my heart is speeding up, I'm noticing that my breath is more shallow, I'm noticing that I feel restricted, I'm noticing that I feel tingly in my fingertips. And just simply acknowledge, this is probably adrenaline, this is probably cortisol, it will pass. And so we'll talk more about that at future conversations. So another question that came in is how do I know if it's a panic attack or if it's actually something really dangerous? And so the really important thing about this is to decipher are you healthy or is it health anxiety or is it a trauma trigger? And so the most important thing that you can do is to get the answer is to talk to your doctor and make sure that you have somebody that's doing a head to toe examination, checking blood work, looking at your thyroid and your hormones and looking at your red blood cells and all of the things, right? To have somebody that you trust that can look at that with you and then make sure that you're not having to be your own doctor and that you're not relying on Dr. Google. And when your doctor that you trust is able to give you a clean bill of health is that you rely on that and then you can talk to the anxious parts. And so in terms of knowing if it's something that's really scary or dangerous versus knowing if you're okay and it's anxiety is just get that wisdom from your doctor who knows you. Most of the time, Dr. Google is not right. And so I'd really encourage you to try to not go down that rabbit hole because it just makes anxiety worse. In fact, when I was really in my worst anxiety, my doctor was asking me, how much time have you spent on Google looking up your symptoms? And that was always a really good indicator of how I was doing. So those are the two main questions that came up. And so if you have anything else that I can answer for you let me know. I do have one more question, and it's about adrenal insufficiency and paranoia. And actually, this is such a good question. There's a really strong link between your adrenal glands and how we feel emotionally and mentally. And in fact, your adrenal glands when you're in a state of fight flight freeze, the primary hormone that they release is cortisol. And so you're wondering about adrenal insufficiency, and so we should actually do a whole conversation about that. I think that's a really important thing to assess. And so if you're wondering about cortisol insufficiency or adrenal insufficiency, my favorite way to assess for that is a Dutch test. And it's D U, T, C, H. And so the Dutch test will look at cortisol, but with cortisol, what's most important is the rhythm of cortisol. And secondarily is how your cortisol is being converted. Is it being converted into an active cortisol or is it being converted into inactive cortisol? And is there enough and at the right time? And the Dutch test will tell you all of that. And so maybe we'll do a whole video where I teach you about the Dutch. In fact, I actually have something printed and it is all about adrenals and cortisol. And so if this seems like a really fun, interesting thing for us to learn about, then let me know and I'll add that to our list. And so, yeah, there's definitely a link between adrenals and. Absolutely. Paranoia. With paranoia, think about dopamine. And so this is just a little bit of a hack for you. So what happens is dopamine gets converted into adrenaline. And when we're in fight flight freeze mode, our body is demanding that you have adrenaline. And so that can actually change dopamine levels. And dopamine levels are really important in the journey of depression, anxiety, and paranoia. And so the Dutch test will tell you about all of that, too. And so I really appreciate that question. That's a really good question. And we'll get into that more in future videos. This has been. Dr. Nicole, if you have any other questions, let me know. If there are other topics of interest to you, then send over a message. That's how we get a lot of these ideas, is you ask and we answer. And if I don't know the answer, I'll find it. Make sure to check out the link in the bio on my Instagram. There's tons of free resources on there. And then also I have a new membership. It's a project that I've been working on. It's called the Holistic Wellness Collective. And this is the kind of stuff that we teach in there. And we have a back and forth kind of conversation. So anything that you want to learn, we're happy to go over in there. And I have a year of topics that are planned out in teaching about brain science, teaching about hormones, teaching about herbs especially, like how do you use herbal medicine to help combat depression and anxiety, and how do we heal the brain from complex trauma. We can use a lot of botanicals for that. So that's all going to be in the Wellness Collective membership. So check it out. Right now it's a dollar, which is, like, crazy and awesome. So right now, when I'm filming this video in April, it's a dollar. So go and check it out. We have a wait list right now, so get in there. All right. It was nice to see you. I'll talk to.