Panic Attacks and Psychiatry: Should… | Counseling | Therapy

Panic Attacks and Psychiatry: Should I take medication daily or as-needed?

Alex , CAS, MSW, ACSW, LCSW — Founder & executive director

If you have ever told a psychiatrist or primary care provider about experiencing a panic attack, chances are they’ve offered you a limited prescription for xanax or another tranquilizer to use “as needed.” The implication being (from a psychiatry perspective) that if you have another panic attack, you can end it by taking a pill. For some people, having an emergency pill available is powerful enough to decrease their frequency of panic attacks. Other people begin to wonder “should I be taking a daily anxiety medication?” In addition to talking to your psychiatrist, consider the following:

For some people, anxiety about panic attacks can cause a panic attack

Panic attacks are your body’s response to heightened anxiety. During a panic attack, you may experience any of the following: racing heart rate, shallow breathing or difficulty catching your breath, a sensation of choking or suffocating, nausea, sweating or feeling hot, muscle tension, and fear that your panic attack is endangering you. This last piece is key: anxiety about the panic attack itself is part of what makes the experience so unpleasant, and why “as needed” medication can be effective for some people.

Anxiety about panic attacks can increase the likelihood of having them, because it heightens your level of anxiety generally. For some people, knowing that you have a way to manage the panic attack can help decrease anxiety about experiencing one, and thus the likelihood of having a panic attack.

Unfortunately, this is not the case for everyone. If you have panic disorder or severe anxiety, you might benefit from daily, or preventative medication as well. A psychiatrist can help you better understand the causes of your panic attacks, and the best way to treat them.

What are your other supports?

When you take medication, its effectiveness is impacted by the other things you are (or aren’t) doing to manage your anxiety. This is because medication can manage your emotional baseline, but can’t control the number of stressful situations you encounter. As-needed and even daily medication alone may not prevent anxiety nor provide you with effective coping mechniasms if you are being yelled at publicly by your boss everyday, or going through a difficult divorce.

Are you in therapy?

Do you have daily routines that help you manage anxious feelings?

Do you have family, friends or a partner that help you minimize anxiety-provoking situations?

All three of these can help you navigate stressful contexts, and lower the likelihood of experiencing panic attacks. Without them, as-needed prescriptions may not be enough to manage anxious feelings. If you are primarily relying on medication to prevent panic attacks, a daily medication may be more effective. Share this information with your psychiatrist to allow them to see all the ways you are (or are not) treating your anxiety. This will allow them to fully treat your panic attacks.

What can you afford?

Psychiatry services should be a right, not a privilege, but unfortunately in the United States that is not the reality. If you are interested in daily medication, know that in addition to the cost of the pills themselves, you’ll have to visit a psychiatrist as often as once a month in order to make sure your medications are working for you. Depending on the type of medication you take and your relationship with your psychiatrist, this might decrease to 1-2x/year. Psychiatry assessments without insurance can be 200-500$, and medication management appointments can be 70-180.

Private pay psychiatry groups typically offer user friendly services. If you have health insurance, you can often get reimbursed for the services, or you can go directly through them to find a psychiatrist. To learn more about your particular plan, call them or look online to find out what kinds of medications they cover, and what the co-pay for psychiatry appointments will be.

If you do not have health insurance, look into community health centers or psychiatry training programs that might offer reduced-price services. Expect to shop around, finding a psychiatrist that is right for you, sometimes takes a while.

Talk to your primary care provider or psychiatrist

While it is important to know for yourself how panic attacks work, what supports you have in place and what your budget is, you need the input of a trained doctor or psychiatrist to decide whether you should take daily medication, or as-needed. Share the information you’ve gathered from this article, in addition to the symptoms you’ve experienced. They will help you come up with a treatment plan that works for you.

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