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Anxiety and Stress Disorders

Why are my Panic Attacks Getting Worse?

04/03/2008

Question:

I am in my mid twenties and have been suffering from panic attacks for 2 years now. I was on medication for about a year, which seemed to help for a while. However, now that I am not on the medication anymore (Which has been aprx 3 months now) the panic attacks have become increasingly worse in severity, length, and frequency.They may occur 3 or 4 times a day lately. I understand how to breath and stay calm and not let the feelings completley overwhelm me, and I have been quite successful at doing this, what is bothering me though is that along with the feelings of not being able to breath, becoming lightheaded, sweating,and having trouble seeing, I am now getting extremely bad headaches, am having great difficulty thinking and concentrating and feel like I am going to lose conciousness quite often. I am having a horrible time driving very far from my house now, and am finding it even harder to drive at night. What should I do? I am thinkning of changing my primary care physician, what questions should I be asking, and what treatmnet options should I consider?

Answer:

Many people with anxiety disorders need medication, counseling or both for extended periods of time (often 1 - 2 years at least).  It is not unusual for symptoms to return when treatment ends, especially if it ends too soon.  If you are dissatisfied with your current primary care provider, then certainly it is appropriate to look for another one.  You want someone who is experienced diagnosing and treating anxiety disorders.

If you did not also see a mental health provider like a counselor, therapist or psychologist previously, then I would recommend doing so.  While both medications like SSRIs (selective serotonin reuptake inhibitors, like sertaline and fluoxetine) and counseling (especially cognitive behavioral counseling) are effective treatments for anxiety disorders, research has shown that the most lasting effects come from using a combination of counseling and medication.

Anxiety disorders often wax and wane.  At times, they cause few if any problems for a person, while other times in one's life they can be quite debilitating.  While an occasional person has one episode of anxiety and never suffers again, it is more common for anxiety disorders to have some persistence in life.  If you begin experiencing symptoms again, it is appropriate to seek help again.

Good luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati