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And, for me, panic attacks = cannot inhale, muscles so tight that it feels like my ribs are all cracked and the broken ends are jabbing into my body. They have very little ramp-up (maybe a 10 sec warning) and boom, full force like a safe has been dropped on me. And, even thought I tell psychologists that I KNOW I'm not going to die, that doesn't change the physiological response to not being able to inhale because your entire abdomen and throat have locked up. So, their whole solution was that if I'd just admit that I wasn't going to die (and I know this because if you pass out the body relaxes), then the panic attacks will go away. They just could not buy into that fact that I did know that and that somehow my body still refused to follow my conscious control. They would say breath, and I would breath as best I could... but you try to deeply inhale with a dozen knives stuck into your body all over. It's just like a calf spasm, you try to lengthen the muscles and it pulls back and spasms all the harder. In the end, their solution was Ativan which makes no sense because it takes 20 min to take effect and my panic attacks are usually under control by then, except that then I'd be too doped up to do anything for the next 5 hours.