I’ve had severe panic attacks on and off since I was 16 years old. Although I may never be able to pinpoint their exact cause, I’ve long suspected that some of the traumas I experienced as a child (divorce, abandonment, custody battles, and verbal abuse) contributed to my panic disorder.
Recently, though, my therapist mentioned something in passing that illuminated the whole phenomenon for me in an entirely different way. She said that when we hold our emotions inside, they tend to kind of morph into conditions like anxiety and panic.
A lightbulb went off in my brain then: I could picture myself, a young girl, witnessing and experiencing all sort of things that I now know were most certainly traumatic, and basically just standing there absorbing them all. I was always the “good girl,” whom everyone thought was so resilient despite all the difficult things that were unfolding.
I learned to tightly and deliberately hold my emotions inside — partly so that I could please the adults around me, but also so I could protect myself from feeling how enormously hurt and shamed I was by some of the things I was experiencing.
But what became of all those feelings that I stuffed inside? They certainly did not go away, and I was rarely given space to just feel them all, without judgment or shame. Could they have shown themselves in other ways — perhaps expressed as panic?
Fleshing Out the Theory of Childhood Trauma Contributing to Panic Disorder
Nicole Amesbury, a licensed mental health counselor (LMHC), psychotherapist, and Head of Clinical Development at Talkspace, tells me that my theory about the relationship between childhood traumas and panic disorder makes absolute sense.
“It has been well established that traumatic events may trigger anxiety disorders, especially in someone who is susceptible because of additional biological or social factors,” she said.
Pretty much everyone in my family has some sort of anxiety disorder, so it stands to reason that I would have a propensity toward the condition in a general sense. But, for me, panic attacks have been the hallmark trait of my anxiety disorder. I can have periods of low-level anxiety — sometimes for months or years — and then be triggered by something and end up with several months of severe, debilitating panic attacks, often followed up by newfound phobias (my phobias get recycled every few years, based on what my latest bouts of panic attack involved).
So, again, why does my anxiety disorder show up in this particular way? And could it have something to do with the precise way I processed my emotional experiences from my earliest years?
Yes, says Amesbury. “As children, we are vulnerable and we are just learning what the world is about,” Amesbury tells me. She explains that specific phobias (like fear of spiders, for example) are quite common in childhood, and can begin as a result of one traumatic exposure. Likewise, if a child experiences a more global trauma (for example, a threat to the integrity of their family, as was the case in my experience), it is quite possible and understandable that they would develop a full-blown panic disorder.
But it’s not just the events that children experience that make them more vulnerable to this disorder, Amesbury explains: it’s how they are or aren’t helped through them, and how they are taught to process and make sense of them.
“The more confusing and complex the experience(s) are, the more difficult it can be for the child (and then adult) to feel secure and safe, especially, if a caregiver was not able to help the child after the experience,” Amesbury explains. “Young children do not know and cannot find the words to express what they do not understand and so these mysterious experiences in childhood can represent just that, a memory of the fearful unknown.”
This insight resonated with me deeply — and probably does with many people who have experienced childhood traumas. I did not have the language or the understanding to make sense of what was happening around me. My parents, though they tried to help in certain ways, were often quite absorbed in what was happening to themselves. Not only that, they simply were not equipped to help me process the events that were unfolding.
So what happens when these emotions are held inside — repressed, unexplored, and uncared for? Simply put: they don’t go away. They lie in wait, Amesbury explains, and once triggered, can manifest as an anxiety attack or panic attack.
Amesbury used the metaphor of a message in a bottle to illustrate how this works. “Imagine someone ship-wrecked and lost,” she says. “They write a SOS message in a bottle that gets thrown out to sea and it is just floating, waiting for someone to find it, read the message and then offer help. The message in the bottle is like the old memory that triggers anxiety.”
I love a good visual like that. For me, I see my body as the bottle, and the messages as emotions that have built so much pressure inside me over the years that when the message is found and read, the bottle just basically bursts — all the emotions spilling out through the shattered glass. This is how intense panic attacks feel for me.
How to Treat Panic Disorder Related to Childhood Trauma
The good news? (I promise there is some!). Amesbury says that once you are able to understand the “messages” that you have bottled up you can “find your way and navigate the waters more easily and confidently.”
In other words, anxiety disorder (including panic disorder) are relatively easy to treat, says Amesbury. She doesn’t recommend one type of treatment in particular. Sometimes panic disorder and PTSD are brought on by one particular trigger, but sometimes they happen spontaneously and it becomes difficult to trace the exact cause.
That is why Amesbury recommends anyone suffering from an anxiety disorder seek professional treatment. “Being assessed and seeking help with a licensed professional is important,” Amesbury explains, noting that treatment plans vary, and depend on “each person’s history and a variety of other factors.”
I know that for me, therapy has been enormously helpful over the years as I have worked through my panic disorder. I have successfully used methods from Cognitive Behavioral Therapy to combat my panic attacks directly, as they are happening. But one of the most important things I have learned over the years is the power of speaking my truths and telling my story — both in therapy, and out.
Probably the worst thing I can do as someone with a panic disorder is to keep my emotions inside — and it’s something I have had to learn over and over throughout my life, unfortunately. Holding your feelings inside is something that is very hard to change, especially when you have been doing so all your life.
But I’m working on it. And I am so grateful to have found therapists and compassionate people in my life who “hold the space” for my feelings, and allow me to express them safely, and without judgment or fear.