Living with Panic Attacks: A Physician’s Personal Reflection
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Kana Yamamoto, M.D., Ph.D Physician, Medical Governance Research Institute
The “Imitecho (Medical Examination Notebook)” column features reflections by a physician on health and everyday life. In this installment, Dr. Kana Yamamoto, a physician at Navitas Clinic and the Medical Governance Research Institute, reflects on panic attacks from both a professional and personal perspective.
Shortly after I moved to the United States, I was constantly confused by small, everyday situations. Shopping in English, making hospital appointments, post office procedures..., and so on. I couldn't speak, and I couldn't even understand what people were saying. Looking back, I think the stress was simply overwhelming. Interactions that would have been trivial in Japanese suddenly felt like insurmountable walls when I had to do them in English. Before I knew it, I was being struck by waves of anxiety that seemed to come out of nowhere.
In my case, I am seized by a sensation of being chased from behind by something enormous, accompanied by an indescribable feeling of lightheadedness. As these sensations intensify, my heart begins to race and I struggle to breathe, so I close my eyes and deliberately take slow, deep breaths. This calms the series of symptoms. It is a coping mechanism I naturally developed to deal with these attacks.
In truth, I have experienced this sensation since much earlier. When I was in sixth grade elementary school, buried in my studies every day for junior high school entrance exams, I would occasionally be struck by an indescribable sense of fear. It was an unspeakable anxiety, as if a massive entity like Godzilla were closing in on me from behind. Yet, when I closed my eyes and took deep breaths, I would strangely feel calm again. Perhaps because I was so single-mindedly focused on my studies, I never sought advice from anyone.
・It wasn't until a classmate in medical school pointed it out to me that I finally realized what it was.
Looking back, I recall being struck by that same sensation, albeit irregularly, during midterms, finals, university entrance exams, and the long stretches of specialized subject exams at medical school. While I was in my clinical clerkship in medical school, I happened to mention this to a classmate. I remember the shock I felt when they asked, 'Wait, isn't that a panic attack?' As I compared my experiences to the symptoms I had learned about in psychiatry lectures, everything started to click. I felt as though my experiences had finally been given a name.
I have never visited a hospital or taken medication for these symptoms. Instead, I have developed my own ways of coping whenever an attack occurs. Especially right after moving to the U.S., the accumulation of small, everyday stresses caused the attacks to happen quite frequently. However, I found that by closing my eyes, lying in bed, and focusing on slow, deep breaths, the symptoms would eventually subside on their own.
The 2024 report from the Salk Institute [※1] particularly caught my attention. Researchers discovered a new brain circuit involved in panic attacks. Their findings suggest that a neuropeptide called PACAP can trigger fear and panic, suggesting a pathway that may operate independently of the amygdala, long considered central to fear processing.
In the same year (2024), the study exploring the effects of breathing on anxiety [※2] also drew significant attention. It found that the brain regions controlling respiration are deeply connected to anxiety, providing scientific support for breathing-based practices such as yoga and meditation. Researchers even suggested the future possibility of a "yoga pill" [※3]—a new type of anti-anxiety medication. This implies that in the near future, we may see the emergence of treatments that target anxiety disorders with much greater precision.
・I haven't struggled with attacks for about two years now.
Today, I live with my husband and our dog, and I have found a place in my daily life where I feel truly safe and at home. Of course, when two different people share the same space, misunderstandings and small compromises are inevitable. Even so, I am fortunate to say that I haven't been troubled by the same kind of attacks for about two years now. I feel that as the foundation of my life—my family and my environment—has settled into place, my heart and mind have also gradually grown calmer. I have come to realize through my own experience that behind every symptom, there is a "trigger," and there is also something that acts as a "buffer" to soften its impact.
Panic attacks may be more common [※4] than many people realize. Anxiety sometimes arrives without warning, and there are moments when we might not even notice the changes within ourselves. That is why I believe it is so important to listen closely to our own inner voice in our daily lives, and to remain mindful of the subtle shifts in those around us.
The latest research reassures us that there are clear biological reasons behind our mental and physical reactions. If I could go back and speak to my younger self from those difficult days, I would want to tell her: "You don't have to carry this all by yourself."
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This article was originally published in Japanese in AERA DIGITAL. on Jun 11, 2025.
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