An anxious person experiencing panic attacks frequently refers to a set of symptoms that cause significant discomfort. Unexpectedly fast heartbeat, perceived as disorganized, causing terrifying fear of death, sweating, leg weakness, dizziness, negative thoughts, and shortness of breath. 
 
"When this happens to me, I really believe I'm going to die or go insane..." The sensation is so intense that the fear of losing consciousness becomes another concern. "What if I go to such a location and have a crisis?" It's best not to go!" Conditioning your life by believing that you rely on others for a variety of activities. However, in these cases, the possibility of losing consciousness appears to be quite remote because fainting is associated with low blood glucose and low blood pressure, and the physiological phenomenon in the anxious crisis is exactly the opposite. The individual is hypervigilant and focused on survival. It mobilizes all senses and physiological resources to stay alive in the face of what is perceived as a threat to life itself. The most disorganized aspect of this event is that during the physiological and psychic mobilization, the subject lacks an object to direct this energy towards and which is contained within itself. The physical and psychological toll is enormous, which explains why extreme tiredness is also reported after a panic attack. 
 
Because hyperventilation causes an imbalance in the relationship between carbon dioxide and oxygen in the brain, the symptoms can resemble fainting, so one of the first recommendations is to try to control your breathing by inhaling and exhaling for a few minutes, enough to allow the return of some calm. 
  
A) Breathing exercises are important not only during crises (which can last between 10 and 15 minutes), but also outside of them. 
  
B) They assist the individual in focusing on himself and better understanding his physiological process. 
 
C) There is a domain of contact with the body that can be developed through breathing exercises and is critical in a person's ability to control himself. 
  
D) Other activities, in addition to exercises and breathing, can help people regain confidence and self-control. Physical activity, nature walks, painting, playing an instrument, sauna, and massages are all options. You should primarily seek out activities that give you pleasure. That activity that allows the release of essential endorphins in the regulation of our mood. 
 
But what causes panic attacks? 
  
Several factors (isolated or associated) are to blame for the emergence of this psychic and physical reaction. They are inextricably linked to their emotional/relational experience lived during an era or period (time/space) of their development during which the subject experienced a traumatic experience. Bullying, domestic violence, sexual violence, or a rigid, castrating, imposing education with no room for expressing what you feel or think are examples. 
The person feels completely alone, isolated, and in a context that repeatedly jeopardizes their psychological and/or physical integrity during a specific period (time/space). Feels completely powerless to deal with these aggressions, unprotected, threatened, a victim of blackmail, disappearance, and loss of love, either by peers or by those to whom they should turn (parents, teachers, bosses, police), who, due to inexperience or ignorance, can expose it further, or worse, they can be the aggressors. For example, by a teacher who says inappropriately, "We all have to be friends," or by parents who say, "You have to be strong," or by magical solutions like "hit them too," or by the boss who says, "Perhaps you are exaggerating, Fonseca is so playful." The seriousness and consequences of such abuses are not considered, the complaint is repeated, the victim is blamed "you're exaggerating...", resulting in guilt integration and living with it for years. He does not denounce with terrifying fear of retaliation, increased aggression, or fear of endangering those he loves, because threats are taken seriously by him. 
 
The experience gave him a sense of helplessness on the one hand and guilt on the other, which he cultivated, lived, and integrated. In the intrapsychic domain, more or less rigid structures (defensive function) are established that, for better or worse, allow the person to survive (cloaking the self); an adaptive scheme to the other was minimizing aggressions that imply a subjection to external wills and thus a subpression of their own wills and desires, which began to be felt with guilt. The experience of these relationships "taught him" that whenever they were expressed, they were perceived as bad, wrong things, and thus whenever the person realizes himself (listening to himself, in this internal dialogue), he triggers a mechanism of self-repression, blaming himself, devaluing oneself, condemning oneself, the fear of failing, not being able to, or pleasing oneself. (People who develop this type of functioning have very high expectations of themselves as well as others.) 
 
He waits for others to demonstrate the ability to recognize what he has done for "them"... Capability to gain acknowledgement for his actions. In relation to himself, the expectations are so high that he frequently fails to meet them, gives up, or spends more time than is reasonable, always feeling great anguish associated with the need (obsessive functioning) to have everything justified, perfect, and without failures. It is the need to have everything under control in the present, in a different relational context that mobilizes past emotional experiences. 
 
This is where the biggest problem lies, the need to have everything under control. As previously stated, it was in anticipation of adverse events (the person lives under the unpredictability of the other's behavior) that the person was resisting, surviving, "escaping" conflicts, finding solutions for others, and that made it possible to minimize physical, psychological, or both aggressions, to survive by pleasing the other. 
 
As a result, asking for help is always difficult, trusting someone presents itself as a great challenge, as well as setting limits, with the person often accusing extreme tiredness, difficulty sleeping, ruminant thinking stemming from the insatiable desire to please everyone, the endless amount of recognition desired to receive, as well as the fear of criticism and failure. 
 
Although panic attacks occur more or less unpredictably, they occur when the person feels more pressure (work, family) and there is a gradual generalized and unnoticed acceleration (of the body and thought); when it is necessary to deal with conflicts, make decisions, and which culminate in the panic attack that is normally experienced in safe places (i.e. in the gym, in the classroom, at home, in the hospital, etc.) it is as if the unconscious authorizes disorganization because there the person is safe, there he can have help. 
 
This is a problem with a solution, which requires the specialized help of psychotherapy, which can significantly improve the person's quality of life. A self-awareness that allows him to perceive himself without constantly blaming others or himself. This enables him to create a space "of thinking," in which all of its parts have a place. As Odgen would say "It is possible to hear all the parliamentary benches of our thinking". 
 
Miguel Rodrigues 
  
Relational Psychotherapist Psychologist