Panic Disorder - Nature or Nurture?

When I developed Panic Disorder in 2023 I found myself asking "why?" a lot. I still do to be completely honest.  Why has this happened? Why me? Why isn’t anyone else suffering like this? Why isn’t anyone helping me? Why can’t I fix this? I had no understanding of what was happening to me and had so many questions that needed answering.  I think the biggest and most important question was “why me?”.  Was it something I did wrong? Was it something I'd experienced? Or was I simply born this way?

Nature

Research suggests that people with a family history of panic disorder, anxiety, or other mood disorders are at a higher risk of developing it.  People born with panic disorder may have differences in brain structure, chemistry, and function compared to those without it. These differences impact how they process fear, stress, and anxiety.  An overactive amygdala is the key element of panic disorder and it seems that this can be inherited.

Looking at my dad’s side of the family there is definitely a lot of anxiety there.  However, I don’t know of any relatives that were diagnosed with panic disorder or agoraphobia. 

Something so biological in the way chemicals are being released into the body, and how the mind and body are reacting to that, makes me think that it has to be in the genes. 

I personally have always had to manage strong emotions, whether those emotions are sadness, happiness, anxiety or anger.  The biggest challenge with this has always been, without a doubt, getting other people to understand how hard that is.  It's very clear to me that my son also has to deal with strong emotions quite regularly and I wonder if he inherited that from me.  Out of my two sons he is the one that is physically more like me, so does that mean the chemical makeup in his brain is like mine too.

We can’t discuss the nature side of panic disorder and not talk about hormones.  Hormones can go jump of a cliff as far as I’m concerned.  A very high cliff, with very sharp shards of glass at the bottom. I absolutely hate my hormones! The anxiety that can come from an imbalance of reproductive hormones in a female body is unreal.  Their influence on the mind and body can be so profound that perimenopausal and menopausal women have developed panic disorder in their forties and fifties having had no previous issues with their mental health.  I sometimes wonder whether my age and my hormones are making my already strong emotions even stronger.

Nurture

Even if someone has a genetic predisposition, environmental triggers - such as trauma, stress, or major life changes - often play a major role in whether the disorder develops.  There are hundreds of stressors in every day life.  If these are not managed properly, your bucket (as it is referred to in many mental health circles) will soon start to overflow.

Many people will suffer at least one 'life trauma' in their lifetime.  Childhood abuse or neglect, physical or emotional trauma like a car accident or an assault, losing a loved one, experiencing or witnessing violence in some form are all events that can trigger a trauma response.  I know of a few people whose panic disorders began after a life trauma.

It doesn’t have to be a dramatic event that can influence the panic response.  If you’ve grown up in an environment that didn’t feel physically or emotionally safe then that will stay with you into your adulthood. But then the opposite of this can also have an influence - you have been overprotected as a child and not allowed to develop the confidence to feel safe in yourself and trust that you are capable of overcoming.  I think this may have been a strong influencer for me.  I’m the youngest of three with a gap of six years between me and the middle sibling, so growing up I had four people always protecting me from anything that may cause me any kind of physical or emotional pain.

How we interact with our children is terrifyingly important.  We can think that what we’re doing is going help them in some way, but it could in fact be doing more harm than good.  Sometimes I find the responsibility of that so overwhelming, it can leave me wondering what things am I doing now that will be brought up in my sons’ therapy sessions in twenty years.  That may sound a little overdramatic but the way we interact with our young people leaves a lasting legacy on their emotional wellbeing.

When I started secondary school at eleven years old I was suddenly introduced to the pain of being bullied.  I mean it was day after day after day. It isn’t any wonder really that my brain believes the outside world isn’t safe and at home I am protected, when it was gathering evidence to support this theory at an early age.

The perfect recipe for a Panic Disorder Cocktail

Asking the question “why do I have panic disorder?” is never going to give you a simple, clear cut answer.  I believe the way I am was just the perfect mix of DNA and environmental factors that resulted in my brain not feeling safe anymore.  Is knowing why really going to help me recover?  I suppose knowing that it’s not actually my fault and I didn’t do anything wrong makes me feel a bit better. 

Was it nature or nurture? Or both? Does is even matter? It’s what I (me, no one or nothing else, just I) do next that’s going to help me move forward now.