201. I have had panic attacks, and take medication to ward off more attacks, but I still feel anxious most of the time. Can a psychologist help me with this problem?

A panic attack is a cluster of severe physiological symptoms which occur together in response to a specific stressor, or sometimes occur spontaneously, without an apparent trigger. Symptoms include heart palpitations or increased heart rate, sweating, shaking, shortness of breathe, a choking sensation, nausea, dizziness, a sense of detatchness from self, fear of losing control or dying, numbness, and chills or hot flashes. These are severe anxiety symptoms which cause extreme physical discomfort, and a fear of physical illness. Many people experiencing a panic attack go to the emergency room because they believe they are having a heart attack.

Both anti-anxiety medications (such as xanax) and SSRI anti-depressant medication (such as zoloft) are often prescribed by physicians to ward off panic attacks. However, this is a psychological condition, and the cause must be identified and resolved to prevent ongoing attacks. The medications will be effective in controlling the most severe symptoms, but do not eliminate the cause of the problem. Additionally, most anti-anxiety medications are habit forming, and not recommended for long term use. 

Psychological treatment for panic attacks and the underlying anxiety triggers is very effective. A combination of psychotherapy and behavior therapy (including both relaxation training and desensitization) is frequently used. Your psychologist will work with your primary care physician to coordinate treatment, if you are taking medication. Psychologists and PCPs often work together with this type of problem, with the goal of eventually eliminating the need for medication.