This isn't something that is taught in medical school, although it should be.
The great Dr.
Victor Frankl knew about it.
He called it paradoxical intention.
Basically, in someone who has anxiety and panic attacks, something happened to initiate the first one ever.
That something can be something as simple as complete exhaustion.
You were exhausted and pushing yourself, and eventually something had to give.
Your body erupted in scary sensations and your mind couldn't stop thinking and the sensations made the thoughts worse and the thoughts made the sensations worse.
and a panic attack was born.
After that first panic attack - you remember how horrible it was and you hope it will never happen again, or maybe you are a bit scared that it will happen again.
This teeny bit of fear is actually enough to bring it on again, even if you are no longer exhausted (and if you are still exhausted that's even worse).
So it happens again and all you can think is "oh no, is this who I am now, will this happen to me forever, this is horrible" and you start taking great pains to keep it from happening again.
If it happens while you are driving you stop driving.
If it happened in a store you stop shopping.
You start cutting down your life to only the easy and familiar.
And then you are truly a victim.