Bonus Episode: The 3 Hidden Causes of Your UNEXPECTED Panic Attacks (And How to Fix Them)

Summary

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Podcast Summary: Your Anxiety Toolkit

Episode: Bonus Episode: The 3 Hidden Causes of Your UNEXPECTED Panic Attacks (And How to Fix Them)
Host: Kimberley Quinlan, LMFT
Date: April 3, 2026

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Episode Overview

In this special bonus episode, Kimberley Quinlan, an experienced anxiety and OCD specialist, demystifies the roots of sudden, seemingly “out of nowhere” panic attacks. With warmth and empathy, Kimberley explains that these episodes rarely appear without warning and are often fueled by hidden, build-up causes. She identifies three main sources of unexpected panic attacks, delves into how they interrelate, and provides actionable, science-backed solutions. Listeners will come away with deeper self-understanding and a toolkit for regaining control.

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Key Discussion Points & Insights

1. Sudden Panic Attacks Aren’t Truly Sudden

• Kimberley opens with a vivid description of a panic attack’s abrupt onset (00:02), reassuring listeners:
  “You’re not alone, you’re not broken... there are skills and things you can learn to help manage that anxiety and that panic in that moment.” (01:30)

2. The Three Hidden Causes of Unexpected Panic Attacks

Cause 1: The Steady Build Up of Stress

• Often, people experiencing “out of the blue” panic have been dealing with cumulative stressors—poor sleep, skipped meals, dehydration, excessive caffeine, or life worries like finances, relationships, or health (02:45).
• Even when coping “well,” baseline anxiety rises unnoticed, leaving one vulnerable to panic.
  • Quote: “It does impact your well-being. And even if you’re coping really well, it can cause you to be more vulnerable to having panic.” (03:38)

Cause 2: Interoceptive Sensitivity (Body Sensation Awareness)

• Some people are particularly sensitive to internal bodily cues (rapid heartbeat, chest tightness, dizziness, etc.) and may misinterpret normal fluctuations as threats (04:04).
• This hypersensitivity leads to “fear of fear”—becoming terrified of the sensations themselves, which only worsens symptoms.
  • Quote: “The majority of people I treat with panic disorder... their condition comes down to a fear of fear itself.” (05:10)
• A cycle emerges: noticing a sensation → fearing it → increased anxiety → more intense sensations.

Cause 3: Stacked Avoidance

• Avoiding anxiety triggers—whether situations, emotions, or even specific sensations—can provide short-term relief but increases long-term vulnerability (06:36).
• Each avoided task, feeling, or sensation adds to an internal “stack.” Eventually, the system overloads, resulting in a panic attack or even nocturnal (nighttime) panic.
  • Quote: “The more you avoid, the more your brain interprets the world as dangerous.” (07:00)

3. How to Fix and Manage These Causes

Fix 1: Daily Self-Care & Stress Management

• Foundational habits such as eating regularly, hydrating, sleeping well, getting sunlight and exercise, and setting aside downtime replenish resilience and lower baseline anxiety (08:22).
• Kimberley emphasizes doing “what needs to get done” while still taking care of oneself:
  • Quote: “Daily self care and stress management is going to be key because in many cases we can’t take the stressor away.” (08:54)

Fix 2: Interoceptive Exposure

• Gradually and deliberately exposing yourself to feared sensations (e.g., mimicking a tight chest) helps “unlearn” that these sensations are dangerous (09:47).
• This technique (to be covered more in future episodes) trains the brain to tolerate normal body fluctuations non-judgmentally.

Fix 3: Exposure to Avoided Triggers

• Face what’s making you anxious—be it unfinished tasks, social situations, or distressing emotions.
• By reducing avoidance, you communicate safety to your brain and break the cycle of increased fear and panic (10:40).
• Kimberley shares client examples where procrastinated tasks and “whooshes of panic” are linked (11:30).

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Notable Quotes & Memorable Moments

• “If you’ve overestimated the risk and underestimated your ability to cope, you might find that your brain interprets it as even more dangerous.” (04:37)
• “This avoidance can be both physical things you physically avoid... or simply that you’re avoiding an emotion.” (06:50)
• Closing encouragement:
  “Please keep an eye on these, but please be gentle along the way.” (12:30)
  “It’s a beautiful day to do hard things.” (13:33)

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Important Timestamps

• 00:02-01:30 – Introduction and reassurance
• 02:45 – Build up of stress as hidden cause
• 04:04 – Explanation of interoceptive sensitivity
• 05:10 – Fear of fear cycle
• 06:36 – Stacked avoidance, nocturnal panic
• 08:22 – Self-care as a practical strategy
• 09:47 – How interoceptive exposure works
• 10:40 – Exposure to triggers and practical client cases
• 13:33 – Empowering closing message

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Tone & Style

Kimberley maintains an encouraging, practical, and compassionate tone throughout—making even dense psychological concepts approachable and actionable. She speaks directly to listeners’ struggles, using real-life examples and infusing hope at every step.

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Key Takeaways

• “Out of nowhere” panic attacks are almost always traceable to hidden triggers: stress build-up, sensitivity to bodily sensations, and a pattern of avoidance.
• Managing stress, learning to interpret bodily cues from a place of curiosity (not fear), and bravely facing what you avoid can drastically lower panic recurrence.
• Healing is not about becoming fearless, but about gentle courage in the face of discomfort—and self-compassion always.

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Final Encouragement

Kimberley’s mission is to equip as many people as possible with tools to reduce suffering. She invites listeners to share the episode widely—with the reminder:
“It’s kind of like chocolate—it’s better when we share it.” (12:59)

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For those wanting a deeper dive, Kimberley’s online course ‘Your Anxiety and Panic Toolkit’ at cbtschool.com provides step-by-step guidance and resources on these evidence-based skills.

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Transcript

[A]

You're sitting there completely calm, and then out of nowhere this whoosh hits you. It's come completely all of a sudden. And you are sitting there all of a sudden overwhelmed with a racing heart rate. Maybe your thoughts are racing, maybe you feel like you're completely in a freeze state, maybe you're feeling dizzy. Something is definitely wrong. This is the definition of you having a panic attack. But here is what nobody is telling you. This panic attack didn't just come out of nowhere. There have been hidden triggers firing below the surface that you didn't even know about. And today I'm going to help you understand what exactly those triggers are and what you can do to manage them. Hello, my name is Kimberly Quinlan. I am an anxiety specialist and I am on a mission to help equip 10 million people. Yes, I know, 10 million people. That's a lot of people. I want to help give folks, those who don't have access to one on one care, helpful science based skills so that they too can manage their anxiety. If you feel like this is something that would help someone you care about, please do share it with them. It'll help me with my mission to help other people to create less side suffering. I feel like my mission on this earth is just to help reduce suffering in any way I can. And this is the one thing I actually know about, so we're talking about it today. So if you are one of those folks who've had this sudden whoosh, this sudden panic attack, you're not alone, you're not broken. And I want to really help give you some hope today that there are skills and things you can learn to help manage that anxiety and that panic in that moment. Now, by the end of this episode, you are going to understand your panic attacks on a level that most people never even reach. And number two, I'm going to give you some real tools to start taking back control. So let's go over the three causes of these sudden panic attacks. Number one is your body has had a build up of stress. I cannot tell you how many people I have seen in my office who have come to me and said that out of nowhere they were doing fine and all of a sudden, boom. They were hit with this panic attack. Now this is commonly related to a slow, steady buildup of stress. Poor sleep, skipped meals, dehydration, overloading caffeine. Now these will all raise your baseline of anxiety. But then it's often like these generalized stresses as well. Money, time, schedule, work, kids, family, relationships. As the stresses build up, illnesses, health, as they build up, it does impact your well being. And even if you're coping really well, it can cause you to be more vulnerable to having panic. And so stress is one of the most common reasons we see people have these sudden panic attacks. Now the second reason we see people have sudden panic attacks is what we call interoceptive sensitivity. Now what this really means is that you're a sensitive to physical symptoms of the body. When you have these physical symptoms, maybe a little bit of an increased heart rate, maybe it's a little bit sweating, maybe it's an itch, maybe it's a tightening in your body. There is a cycle that your brain goes through that makes it worse. So what happens here is for folks who have panic attacks or folks who have panic disorder, they often are hyper attuned to these internal sensations. So even a certain little flutter can trigger off this fear that it's going to be a heart attack or a little bit of an itch or an ache might be a fear that it's cancer or a fear that you're losing control. And so this sensitivity feeds on itself and it creates a fear cycle. Now what also happens here is we build up a fear, fear of fear. Let's say your main symptom of anxiety is a tightening in your chest and a little bit of a sped up heart rate when you have that sensation. If you've overestimated the risk and underestimated your ability to cope, you might find that your brain interprets it as even more dangerous, sending out more anxiety, which causes you to feel even more out of control and even more in threat. And now again, you're stuck in that cycle. The majority of people I treat with panic disorder is their condition comes down to a fear of fear itself. And that often reinforces panic. And that what happens is once you've had the panic attack, now you're afraid to have the next one. And you're even more sensitive to any increase in heart rate, any hypervigilance, any racing thoughts, any tightness in your chest, and the cycle plays out.

[B]

Now, as you know, I have a private practice. I have six amazing therapists in Calabasas, California. However, we do not take insurance. Now if you are looking for insurance covered OCD or BFRB treatment, I want

[A]

to let you know about nocd.

[B]

NOCD provides face to face live video sessions with specialized licensed OCD therapists. Now their therapists use exposure and response prevention. We know this is the gold standard for ocd. So you can be absolutely confirmed that you're in the right place there. And they have a clinically proven app that helps you stay connected to your therapist and others who have OCD between sessions. So you'll always feel supported. Now the cool thing is no CD is available in all 50 US states and even internationally and they accept most insurance plans, making it affordable and accessible. We love that. Now if you think you might have OCD or you're struggling to manage your symptoms, you can book a free call. Just click the link in the show [e-mail] I am honored to partner with NOCD. I want to remind you that recovery is possible. Please do not forget that. Now big hugs and let's get back to the show.

[A]

Now the third cause of these sudden panic attacks is stacked avoidance. Now you might be finding that you have had some anxiety in your day to day, but you avoided it. And then you found some other things in your life that created anxiety and you avoided that. And so you're actually feeling fine, you're feeling relief because you continuously have avoided things but, but they stack on top of them. Avoidance in and of itself is not a problem. But if you're stacking avoidance upon avoidance upon avoidance upon avoidance, again you're reinforcing that fear. The more you avoid, the more your brain interprets the world as dangerous. And this avoidance can be both physical things you physically avoid. It can be physical in your sensations. Like we talked about, with that interoceptive sensitivity, you might be avoiding things that trigger a physiological sensations in your body, or it could be simply that you're avoiding an emotion. I've had clients who haven't really had a lot of anxiety in their life, but maybe they're going through a stage of grief and they've avoided that grief. They're doing everything they can to compartmentalize it and not feel it. And over time that avoidance stack does add up. And they have had sudden panic attacks out of nowhere. Or maybe they're having nocturnal panic attacks in that they're fine during the day, but they're waking up back to back with sudden whooshes of anxiety, panic sensations, panic symptoms, and it's causing them to stay awake and they're having many, many of these nocturnal panic attacks. This is often because of stacked avoidance. Now I also want to give you some strategies and some skills to help fix this. As we always talk about on your anxiety toolkit. My goal is to give you as many evidence based skills as I can. The first fix is to really look at your daily self care. I want you to prioritize, rest, nutrition, water, Exercise, taking breaks, getting support, getting some sunlight, meditating if you can. These are going to help fill your battery. If you're running on a low battery every single day and every day you hit the bottom of the battery and battery is almost about to run out. Yes, your body is going to have panic or it's going to have some chronic struggles. It's going to to start to have headaches or migraines. You're pushing yourself beyond the capacity of what our human brain can do. So daily self care and stress management is going to be key because in many cases we can't take the stressor away. Maybe you've got an ill child or a financial struggle or you've got a test coming up. We can't just avoid that or make it go away. We have to stay present and get the done what needs to get done. But we can take care of ourselves and as we do that. Now fix number two is interoceptive exposure. Now I'm going to do a whole video on this very soon and a whole episode on this, so stay tuned. But interoceptive exposure is where we on purpose expose ourselves to specific sensations that trigger us. If you find that when you have tightness in the chest that that causes you to sort of contract and not want to feel that feeling, we might on purpose gradually ext expose you to that physical symptom. We might wrap your chest with a lot of bandages so that it's nice and tight. What we want to do here is we want to unlearn what we have previously learned. We want to unlearn that it's dangerous to have a tight chest or to have a tingling in your stomach or butterflies in your stomach. We want to learn to have that sensation from a non judgmental and a willing perspective. Now fix number three is we want to then practice exposing you to the triggers that you have been avoiding. This could be people, places, things or emotions or sensations. So some of this overlaps. Right. Exposure to triggers, if it's a sensation, could be more of an interoceptive exposure. But if you've been avoiding your taxes, I have a lot of clients who will say had this out of nowhere, whoosh of panic the other day and I'll inquire, like what's going on in your life? Like how are you coping? Well, I'm very, very stressed. Problem number one. Number two, I have just the list of things I have to get done these days is so long. I have such a long and I've been avoiding it. Ah, there we go. There's the was the cause number three. And when they have the panic, they had that interoceptive trigger, that resensitivity. That's cause number two. So we can see how often these might all play in together. Now, if you're wanting to go deeper into this, I teach all of this in your anxiety and panic toolkit. It is an online course that we have where I teach you exactly what I teach my clients when they have generalized anxiety or panic. Please go over to cbtschool.com to get access to that. It is a course that I love. It's got a workbook you'll work through with me from start to finish that is there for you when you're ready to move on to that next deep dive. But in the meantime, I want to leave you with these three core things. Number one, stress buildup is very important to keep an eye out. And often your baseline was just too high to start with. Number two, we often misread our body signals. Our brains learn that fear can be dangerous if we respond to it as if it is dangerous. And number three is avoidance. Do your best to not avoid things when you're anxious, whether that be physical things or emotional internal things like sensations as well. Please keep an eye on these, but please be gentle along the way. Now, as always, thank you so much for being here. Please do share this. My mission to reduce suffering of human beings will depend on your ability to share this with folks who actually you feel genuinely it would help. So. So if you do have a friend or a loved one and you thought about maybe that would be helpful for them, I would be so honored if you trusted me enough to share this with them. Because again, my goal is to help as many people as I can. I always think I'm not here to play. I'm here to actually make a difference. And so let's do this together. And I joke that it's kind of like chocolate. It's better when we share it. And so hopefully you'll feel comfortable doing that with me. As always, thank you so much for being here. You know I value your time. I know how valuable your time is. So thank you for being here. If you're listening on YouTube, stay tuned. The next video is going to show you how to manage a panic attack in 60 seconds. It is proven scientific relief techniques. I can't wait to see you there. Have a wonderful day, everybody. And please don't forget, it's a beautiful day to do hard things. Please note that this podcast or any

[B]

other resources from CBTSchool.com should not replace

[A]

professional mental health care.

[B]

If you feel you would benefit, please reach out to a provider in your area.

[A]

Have a wonderful day and thank you for supporting CBTSchool.

[B]

Com.