I think the answer is the same for everyone what make us different from everyone else. The primary mechanism of a mood disorder depression or anxiety or on our web site of anxiety and panic attacks is stress. What is the primary definition of stress?  It is the belief that your abilities and coping mechanism outweigh stressful things or events of what we have to do. I think a more interesting question is why are their some people who can have panic attacks and are not bothered by them. The answer lies in the definition of a panic disorder, which is that we worry too much about the effect of another attack and therefore look for signs of them. We think that the effect of an attack impinge on our life’s so we become afraid of them. I can honestly say I still have in the back of my mind that when I have an attack and become dizzy I find it harder to work and pay attention to what I am doing. Therefore, you can see that in least for me how panic attack are perpetuated not because I think I am going to die but because I think it interferes with my cognitive functioning. The answer for me is to pay less attention to the dizziness or accept the dizziness because it is there right now (and striving for it to be gone just causes more stress) and get on with the job at hand.  

There are two kinds of suffering, one is the pain, and the other is what we say all day about the pain. If we get rid of the second suffering, which is CBT, then we lessen the effect of a panic attack.

It is also true that once we have an attack and have enough time to build up a healthy amount of cognitive distortions that this is where we get into trouble. What causes us to have an attack where someone else would not is the stress associated with the belief we cannot cope. If you think you cannot handle the job promotion then you may be predicting your outcome of the promotion before you even get there and see if you can. This belief may cause you to be overwhelmed and cause you to do poorly in the promotion and as a result, you may lose your job (if you have no stress coping mechanisms). If you had resiliency to stress and a positive outlook you may say “there are many new things in the job that I do not know how to do but I am up for the challenge” this is a different response to “I cannot do it”.

The primary mechanism to an attack is a reaction to stress rather than a response to stress. The person who does not have an attack is responding to stress the person who has an attack is reacting to stress. A reaction is an automatic thinking in our heads some of which new people on the site may not be aware of yet. This is why we are asked to look into ourselves to see what we are saying during an attack. What we typically say are reactions such as I cannot take this anymore or I hate this feeling of fear or my heart is pounding I am going to have an attack. I put the heart attack one in for new people to the site to see how relief can come from simply understanding that you will not have a heart attack (this is why some people can get relief by reading session one because they thought something bad was going to happen).

This is where your core beliefs come in, a core belief or a filter in the mind that creates our perception of the world is the thing that causes an attack. The misperceptions are found in the site and are jumping to Conclusions, Catastrophizing,  and All-or-None Thinking. I do not believe this is an exhaustive list. Also I believe it is not by accident that in the toolbox the auxiliary session deal with relationships, dispute, worry, shyness and sensitivity, role transition, grief and loss all stressful event in our lives. I also notice that the leaders are talking about stress in their information session, which I also believe is not by accident.

The way this site addresses panic attack is to expose yourself gradually to the situation to a point where you experience 80% anxiety or stress. Then wait to for a decreases to a lower level so that you can go further to leaving the house. All this is teaching you how to respond to stress of leaving the house using tools such as the relaxation response or CBT to get the negative thought out of your head. I believe that each negative thought especially if fully believed cause a charge or stress reaction.

In my support group we have a person who suffers from depression at work he gets an assignment and his immediate thought was the problem I will have because I have never done this before and as a result, he had lowered feeling. The same thought would have cause anxiety in me so through this example one can see how stress can cause depression in one person and anxiety in another. Put in simpler term it comes back to our filter of how we see the world or family or our selves.  

A word about perfectionism I think in me that I have discover the reason why I have it. The reason is that I think my work is substandard or lacking of an average person. To compensate for the insecurity I try to do things perfectly which never happens which is why perfectionism cause stress because you cannot be 100% perfect 100% of the time.

A final note all of what I said here is my perception and it may not be yours. The insights I think I have are still being filtered through my beliefs that I have. It is possible that some of my beliefs have changed and allowed me to come to some understanding of the situation at least in my case. I would ask that nobody respond to my post rather to accept Davit question and see if you can answer it for yourself. The reason is I do not believe there is one answer. You will notice that both Davit and my post are opened ended in that my post says it is the belief you cannot handle a situation I did not say what situation or situations you could not. In addition, Davit did not say what the core belief for you to have that will perpetuate an attack.

You may be wondering what is the solution to the stress response is stress resiliency. You will notice the stress resiliency that it mentions the relation as the web site does and to be a positive thinker which is a form of CBT (which the site also does or at least tries to get you to stop the false or negative beliefs).

• The brain allows us to get to homeostasis (a balance of your stress system this is how you can cope with stress). I am not going to get medical, but I will say the brain is the part we can control to the stress reaction.
• If we can find reward and motivation in doing things and be positive, this counteracts stress. This part is the part we can control. To be motivated you have to find what gives you life meaning in spite of your symptoms.

Pillars to  resiliency:

v The relaxation response or, (self-soothing) where you show yourself that you care about you as much as you care about your family and all the other people. The site teaches you to box breath and decrease muscle tension as a response to stress rather the sallow breathing and tension, which is reactive to stress. By the way, another relaxation response is to mediate consistently so that you can call on this learned feeling in stressful situations. These are the part of the behaviour aspect or a response to stress.

v Once you have some the relaxation response you can absorb the use of CBT more effectively to see alternative thought to I am overwhelmed. It is very hard to cultivate alternative thoughts during an attack because you are so consumed with it

v Social support is also another thing you need to have a counter balance to stress. Can you see how isolation of yourself has contributed to your stress reaction. When you have no support how can you get relief. Social support helps mitigate against separation stressors.

v To get support you have to give support. If no one could give support then we would never be able to get the support we need to counteract stress. This is a circular argument about the above where I say you need social support to get it someone has to give it.

v You need to believe consciously about positive outcomes in your life. This will come after the above pillars grow in strength. Belief there is a purpose in life we will look at your day to find this.

v Belief in a higher power I cannot help in this area.

v Develop a positive outlook on your life. You do your best when you think positively about your future. This is the last step but can be used if you think you are on a journey of self-discovery. That everything you learn about yourself can help you to progress in to homeostasis in the future (stress resiliency).

To put this in perspective let us pretend all of what I have said is an equation:

                                                        Stress

                                                    Resiliency

Can it be as simple as accepting that you are you and it is okay. And honestly believing it. Could this be enough to remove the reason to panic. You know, just being you and liking the you that you  are. Not having to work to fit.