PANIC DISORDER has been described as a catastrophic misinterpretation of mildly elevated physiological responses to the environment. It is considered one of the Anxiety Disorders and, as such, is felt to be related to applying the wrong response to a given situation. That is, fear is an adaptive function that all animals (human and otherwise) are born with... it is not learned, it is innate. When fear (the response) comes at the right situation (a hungry saber-toothed tiger standing in front of you), you're doing GREAT! Fear makes you move (fight or run for your life)! When fear (the response) comes at the wrong situation (at the grocery store or on an elevator or driving down the highway, for example), you're not doing so great - and you need to relearn when/how to apply fear as originally intended.
Research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for anxiety. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with anxiety disorders (like Panic Disorder).
A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."
With regard to medical treatment, many/most physicians appear to begin with a Selective Serotonin Reuptake Inhibitor (SSRI) to treat anxiety. Because I am not an MD, it is beyond my purview to address medication concerns, however. I do know that Paxil and Lexapro both fall under the SSRI family of psychotropics.
Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of anxiety disturbance... it actually exacerbates the condition(s) [This is especially true with Panic]. So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.
Your psychiatrist *may* know of a CBT licensed mental health professional. Please make certain, however, that they employ CBT practices.
If $$ is a super-big issue, you might want to consider contacting your local Community Mental Health Center. These tend to offer free or greatly reduced cost mental health services, including therapy and/or med management, depending upon your ability to pay.
Thanks. I hope you're well and that this was helpful.
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I just wanted to follow-up with you regarding your comment that COUNSELING does not help with panic attacks. Cognitive Behavior Therapy (CBT) - not talk therapy - is the route to go... Counseling doesn't help and (at worst) can exacerbate the problem. Make certain, if you decide to try it, that your licensed mental health professional (LMHP) is employing CBT - not some "eclectic approach" or merely talk therapy. True CBT can be truly effective.
Thanks. Best of luck to you! (No need to reply)