Mish Ghinej – Panic Attacks Explained

Note on the title: Mish ghinej is a Lebanese coloquial phrase. Ghinej means spoiled or drama queen in this scenario. Mish means not or isn’t. Hence: Not Being a Drama Queen, which I hope will be series on the blog to shed some light about psychological phenomena we often mistake for being a sissy.

We all know someone who is like that poor girl to the right. Irrational reactions to a mild stimulus, or maybe even none at all, that have a sudden onset and don’t usually last beyond 10-15 minutes, are called panic attacks.

People who are more prone to these attacks are so because of several different reasons. One of the reasons is having other psychological disorders, such as Obsessive Compulsive Disorder, Post Traumatic Stress Disorder and phobias. It can also have purely biological causes, such as low blood-sugar (hypoglycemia).

Those are obvious reasons, but one cause I found truly enlightening on what it must mean to experience a panic attack, is people who have over-active chemoreceptors in their medullas.

These chemoreceptors are there to monitor levels of carbon dioxide in your blood. They do that by keeping track of the pH levels of your blood, which is slightly basic at 7.40 ±0.05. Carbon dioxide is packaged into Bicarbonate (HCO3) in the blood, which is a weak acid. Thus, when the pH levels goes somewhere below 7.35, the alarm sounds and your body does its best to compensate for the increased CO2 levels (and thus decreased O2 levels). How? By gasping wildly for air.

Most of you, hopefully, have not experienced this feeling of hyperventilation.

That is not entirely true though. I’m sure as itsy bitsy children, you were taught how to swim. The pinnacle of this experience, is diving underwater, and frantically swimming up for that gasp of air you desperately need. If you’re lucky, you’ll have a delightful sibling or relative who will force your head to stay underwater before you manage to squeeze in that breath. Horrible feeling, right? The fear of death, the frantic need to get out and other behaviors bordering on the insane, are exactly the same feelings someone having a panic attack has…

The reason you need that air so frantically, is that your chemoreceptors detect a rise in CO2 levels and force you to do everything possible to get to that yummy Oxygen. Imagine having that, in the middle of a party, with no big body of water in sight (except maybe the beer kegs). Yup, that’s exactly what people who have panic attacks and subsequently hyperventilate, feel.

A common thing we see being done is a bag handed to the afflicted individual, which they breathe into and out of repeatedly for a few minutes. This is because as a result of high CO2, they breathe in too much, raising the O2 levels in the blood. And like everything, too much of it is bad. So, to restore calm and composure, rebreathing O2-poor and CO2-rich exhaled air eventually restores the O2/CO2 blood balance.

I had the pleasure of meeting several individuals having panic attacks, and understanding that phenomenon has been very rewarding for me. After all, knowledge is always sexy. So, now you know =P

As always, inspired by lectures by Dr. Arne Dietrich, Behavioral Neuroscientist at the American University of Beirut

Further reading: Carbon Dioxide Sensitivity in Panic Anxiety


  1. says

    Hi Gino, i appreciate a lot this beautiful article and the way you had explained the things in each step.bravo very interesting

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