Has anyone else heard this "Caveman Hypothesis" regarding panic attacks?

My kooky psychiatric preceptor insists that the likely basis of panic attacks is in excessive carbon dioxide (that’s why people having panic attacks hyperventilate–to get rid of it). He bases this on the evolutionary “fact” that cave men would light fires and if the CO[sub]2[/sub] got too high, they’d panic and leave the cave.

I think anyone can see the goofiness of the idea, but is he alone? Is this unique to him, or is this an actual school of thought?

Never heard of this theory. And since “cavemen” didn’t usually live in caves, it’s highly unlikely to be true.

I went to grad school in behavioral neuroscience and I have had panic attacks before. I have never heard the theory and it is hard not to see the gaping holes in it from a mile away. That is a kooky theory that doesn’t speak well his general competence. Freud was an almost complete kook too and he is really famous. Maybe he is going for something like that instead of the tried and true scientific way.

Fires create Carbon MONoxide. Creatures and plants create carbon DIoxide.

No, fires create CO2. The only time a fire can create significant amounts of CO is if it is smothered. Charcoal fires, for example, create CO, and some house fires can also create CO. But any fire that has been lit for the purposes of cooking, heating or light is not going to be producing significant amount of CO.

There is that. There is also the fact that those few people who did live in caves only seem to have existed in Europe and western Asia. So by this theory only white people should have panic attacks, which is clearly not true.

Then we have the problem that panic attacks prevent a person fleeing. It causes disorientation, paralysis, an overwhelming sense of dread, feelings of illness. None of those things are going to cause a person to leave their nice warm cave and wander out into the dark, cold night. Quite the opposite.

Then we have the problem that a person could only be suffering from CO2 poisoning in a in high CO2 atmosphere. And in a high CO2 atmosphere hyperventilating won’t reduce the CO2 levels in the blood.

Then we have the problem that panic attacks have never been observed occurring in response to elevated CO2.

Do we have a large enough hole to drive a truck through Shagnasty?

Kooky indeed.


Overview of panic disorders:

From wiki (bolding mine):

Many panic attack sufferers as well as doctors recommend breathing into a paper bag as an effective short-term treatment of an acute panic attack.[22] However, this treatment has been criticised by others as ineffective and possibly hazardous to the patient, even potentially worsening the panic attack.[23] Critics say that this technique can fatally lower oxygen levels in the blood stream,[24] and increase carbon dioxide levels, which in turn has been found to be a major cause of panic attacks.[25]

Panic attacks mimic the normal “fight or flight” response triggered by a real life or death emergency. They would be shaky, sweaty, nauseous, etc. if confronted with an actual danger.

There is actually evidence of a link between elevated CO2 levels and spontaneous panic symptoms in patients who already suffer from panic disorders, at least according to this study.

This obviously doesn’t prove the theory put forth by the teacher in the OP but they might have at least developed the theory based on some real correlation between CO2 levels and panic.

The only times I had anything that may be described as a panic attack was times where getting air to breath was a issue. SCUBA diving, needing air to stay at depth and running out causes a almost impossible to control increase in breathing rate, this also applies with SCBA as well. It’s a feeling that you don’t know if the next breath is coming so you want to take it and find out. So I believe a breathing issue may be part of, perhaps the reason for, a panic attack, but it is sort of counterproductive in some cases.

Could be off-topic, but I have heard that the panic you experience when suffocating, and the forced breathing reflex, is based on CO2 buildup.

So if you were instead to, say, breathe pure nitrogen, you’d just pass out without any feeling of suffocation.

Assuming the preceding is true, perhaps it was this that your “preceptor” has got muddled up with evolutionary psychology or something?

You guys did a good job at explaining exactly why I think it’s dumb. As his student, I was frustrated because of that and because of a number of other quirks. Someone brought up Freud, and this doctor criticised the DSM and Freud while putting forth a poorly explained idea of “neuroticism” to explain all mental disorders.

I was just curious if this was idiosyncratic or if there was an actual school of thought.

The point being that nobody undergoing " the normal ‘fight or flight’ response" is going to run outside of their nice, warm, well-lit cave surrounded by friends and out into the cold dark night. It’s nuts. As a mechanism for getting people to leave a cave it is worse than useless. It’s like getting a rabbit to leave its burrow by chasing it panic. Makes no sense at all. The first response of humans when they panic is to run to home, friends, comfort, heat, light and security. It’s not to run away form their friends into the wilderness in the middle of the night.


Based on my own experience with panic attacks, I could very well see that as a learned response. Especially since one of the things I do to calm my panic attacks is a breathing method that involves holding your breath for a bit–which actually increases the CO[sub]2[/sub] concentration in the blood stream. Thus it would seem that the gas alone is not enough.

Oh, and because pretty much anything associated with a panic attack can precipitate a panic attack in someone with panic disorder. That’s pretty much what the disorder is. Humans are much more conditionable in periods of high emotion. One of the easiest things in the world is to condition a human to be frightened. Heck, even decreasing the adrenal response (via use of a beta blocker) is used to help treat PTSD.