I'm new here. I've had episodic, infrequent panic attacks since age 16, usually went for years and even decades between clusters of episodes during which time I was fully functional, traveled overseas alone etc. Got AIDS in 1998 and had a heart attack in 2002 while on Vioxx, then in 2003 developed resurgence of panic attacks/agoraphobia shortly after beginning new HIV meds. Panic and migraines run in the family. At one point I was diagnosed with mitral valve prolapse, although recent cardiac exams don't show this. Another issue for me is the possibility of dysautonomia - dysfunction of the autonomic nervous system which can trigger numerous symptoms. In 2003 after many ER visits and hospitalization to rule out other causes (adrenal insufficiency, recurrent heart problems) they discharged me on alprazolam (Xanax)and after that have taken that only as needed, although it takes about 40 minutes to work which sometimes means a little suffering. Like many of you, I've been through multiple psychological interventions - biofeedback training, meditation, and cognitive behavioral therapy with modest success. Have yet to try EMDR (eye movement desensitization reprocessing). Have also spent a lot of time surfing the net looking for answers.
After reading several of the posts and questions on this forum, this is what I'd like to say: "panic disorder" and "anxiety disorder" can be tricky diagnoses. In fact, anxiety and panic are often simply symptoms of something else. Like many other symptoms (for example, pain in your abdomen) they can appear from any number of underlying causes. These can be psychological (eg stress), hereditary (relating to hard wiring in your brain), organic (many possible causes from hormonal imbalances or mineral or nutritional deficiencies to pheochromocytomas or other disease processes), the result of environmental factors (such as exposure to chemicals or drugs), or a combination of several of these. So when I go to a therapist who assumes I need to be put on an SSRI or other medication without doing a complete history and if necessary, blood and other tests, I tend to be skeptical because this is at best "trial and error" medicine. My point: If you suffer from anxiety or panic symptoms, do your best to get a real diagnosis. If you aren't seeing an MD, this can be difficult. I'm still not sure exactly what's causing my attacks, although I suspect the HIV meds and dysautonomia. Sometimes the anti-anxiety meds or therapies you are prescribed will be effective in reducing symptoms, but will not treat the underlying problem, which may persist or get worse. While the underlying disorder may be behavioral, it can also be physical. A good history taken by a competent and caring MD will rule out many possibilities.