Hi Petra. It’s not so much that the knowledge of an impending quake will cause a panic, but in the nature of people themselves. There are many different things that will cause people to panic. These are just a few. As you can see anyone of these can and will be present if someone knows that a major quake is going to strike next week, or next month. Take Care…Don in creepy town.

Precipitating causes
Stressful life events that make one feel insecure and helpless appear often in the few months before the very first panic attack, as well as just before a renewal of a round of attacks. For example, a death in the family, a job change, a divorce, or a major move are fairly common. Sometimes these stressful events happen together naturally, as in marrying, getting a new job, having a child on the way and many new responsibilities. The average age of onset of the first panic attack is consistent with these events : about 23 years for agoraphobia, about 16 years for social phobia and about 16 years for obsessive-compulsive.

Immediate Causes
The cause that is probably always present in some form is being trapped in a situation you believe you can't escape from and often can't get help for. The traps can take the physical form of being in a confined, dark, unfamiliar place. I can also take the form of social traps: judgments, criticism, and public exposure. Many attacks that appear to have no cause, i.e. "out of the blue", later reveal their specific origin to a careful observer. The most typical traps are: driving, crowds, buses, trains, elevators, airplanes, churches, movies, malls, stores, public talks, meeting people, parties, restaurants, dental chairs, waiting rooms, hospitals, and being alone.

Physical Causes
This cause is present all the time. It consists of a cascade of stimulants and hormones that are released into your bloodstream and course through your whole body once the alarm of being trapped has started. These changes in sensations and feelings are real, not imaginary, consequences of these stimulants. The stimulants include adrenaline, epinephrine, glycogen, cortisol and up to 20 known substances. Adrenaline, for example, causes palpitations and heart racing, tingling and numbness in the limbs, and sweatiness. Most of these stimulants are metabolized away by the body
in 4 or 5 minutes or so, unless one adds more alarming thoughts

Sustaining Causes
Sustaining causes are those that keep panic going once it starts. The two major sustaining causes are widely recognized: excessive worry and avoidance. Excessive worrying is imagining the worst things that could happen if one returned to the panic situations, e.g. being stuck, embarrassed, faint, be nauseous, etc. This is also called the "what-if's", anticipatory anxiety, or the second fear. Worry keeps a cycle ( worry - anxiety - body symptoms - more worry) going on and worsening. Avoiding the panic situation also keeps anxiety high and makes one more sensitive the panic situation. The more one avoids, the more fearful one gets. Modern therapies target these "sustaining" causes.