Panic Attacks and Vision Loss: A Polyvagal Perspective
For the past three years, I have worked as a therapist supporting older adults with vision loss. While my observations come from a small sample size, I’ve noticed a pattern: an abrupt change in vision puts clients at a higher risk of having a panic attack.
Polyvagal theory offers a framework for understanding this. Stephen Porges explains that a primitive area of the brain is responsible for gut reactions of feeling safe, unsafe, or in extreme danger. Without consulting the thinking brain, the autonomic nervous system then responds to the perceived dangers by entering into fight, flight or freeze. The heart may beat faster, you might become pale or sweaty, or you might tremble or feel dizzy. (Porges, 2011) Panic attacks can seemingly come out of nowhere due to this subconscious chain of reactions.
As vision deteriorates, the brain struggles to interpret the changing sensory input. Many parts of the brain are used to process, store, and understand visual input, and the brain makes a lot of assumptions when processing information received from the eyes. Marked and sudden changes in visual perception are particularly perplexing to the brain. This brain is taxed, so the body gets the message that something is “not quite right,” which can register as unsafe.
In these moments, the nervous system may move into a defensive state—heightening stress and sometimes leads to a panic attack. As the brain gradually adapts to the new level of visual input, the experience becomes more familiar, and the nervous system shifts toward greater regulation. Anxiety and panic decrease, and a sense of safety returns.
The theory is untested, but clients appreciate the idea that the panic attack may be associated with their vision loss. Relating the panic attack to a physiological process rather than a purely emotional one is reassuring for an older adult who may fear having a mental health diagnosis added to their problem list. Understanding that the nervous system is responding to real changes helps reduce shame, and information about calming their body gives them practical tools. This reframing allows clients to feel a greater sense of control in the face of diseases that often leave them feeling powerless.
This perspective highlights the deep connection between our body, mind, and environment. For individuals living with progressive vision loss, understanding this process may bring compassion and insight into why panic attacks sometimes arise.
Tips for Managing a Panic Attack
If you find yourself experiencing a panic attack, here are some strategies tailored for those with low vision:
Ground through touch: Carry a small, familiar object in your pocket (like a smooth stone, a favorite piece of fabric, or a keychain). Hold it and notice the texture as a way to reconnect with your body.
Orient with sound: Focus on a steady or familiar sound in your environment—like a clock ticking, music, or a white noise machine. Let your attention settle on it until your body feels more grounded.
Steady your breath: Inhale gently through your nose, exhale slowly through your mouth, and try making the exhale a little longer than the inhale. Counting can help—inhale for 4, exhale for 6.
Affirm safety aloud: Calmly say to yourself, “I am safe in this moment. This will pass.” Speaking it aloud can help anchor your nervous system.
Seek connection: If possible, call or sit with a trusted friend, family member, or therapist. Sometimes simply hearing a supportive voice can calm the nervous system.
Panic attacks are frightening, but they are temporary. With the right tools—especially ones that work well for your sensory needs—you can ride them out and restore a sense of calm.
References
Stephen Porges, The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation (2011).
Disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you experience frequent panic attacks or significant distress, please seek support from a qualified healthcare professional.
