Thank you for writing. You are not being overly dramatic. You are anxious and hurt. You are even more anxious and hurt because you are anxious and hurt, which only increases the anxiety.
My guess is that you were able to stop self harm, but you didn’t get to the root of what was causing it. It may be that your insistence on perfectionism helped you feel more in control but, as you are finding, being perfect isn’t a long-term solution. As we get older, it becomes more and more difficult to keep it up — just because there are more responsibilities and more decisions to be made. You haven’t developed other skills for dealing with stressful situations.
I can’t make a diagnosis on the basis of a letter, but what you are reporting is consistent with a diagnosis of a panic disorder.
A panic attack is a reaction to intense fear from no apparent cause. The body responds as it would for any fear: Fight, flight, or freeze. Often there are physical symptoms that can feel like a heart attack. People who have experienced a panic attack often say that it can get so bad, they are sure they are dying. The fear of having another one makes them vulnerable to having more. Over time, That fear can cause a person to start limiting their life to situations where they feel they will have less stress and more control. Ironically, their attempts to stay safe can result in social anxiety and a very isolated and limited life.
Some people only have one or two panic attacks in a lifetime. Panic attacks becomes a panic disorder when they keep happening and the person continues to be afraid they’ll have another one. Symptoms include what you describe, chest pain, as well as dizziness, nausea, sweating, heart palpitations, and shaking,
The solution is to deal with the root cause — whatever is causing the anxiety — and to learn new skills for managing it. Sometimes medication is prescribed initially but it is psychotherapy that will give you long-term relief.
Cognitive Behavior Therapy (CBT) has been found to be very effective in treating anxiety. Look for a therapist who has training and experience treating panic disorder using CBT.
While you look for a therapist, you can help yourself by working your way through a workbook on managing anxiety disorders. There are several excellent workbooks available from booksellers. I also regularly recommend that my clients read “Feeling Good: The New Mood Therapy” by David Burns.
Please don’t write off your concerns. They are valid. You deserve to live a life free of such disabling symptoms.
I wish you well.