
Panic Attack, Anxiety, Fear Of Death And Diseases Is Debilitating.

Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 33 year old female
• History of anxiety, panic, and fear for decades
• Complaints of: Bad dreams
Panic disorder (subtype of anxiety disorder) is one diagnosis which can explain almost all symptoms. Other common symptoms of anxiety disorders which can also present in your case are anxiety, nervousness, restlessness, mild irritability, excessive worry regarding own wellbeing, tremor, muscle spasm/twitching, heaviness in body, easy fatigability, palpitation, sleep difficulty and dry mouth.
You may need treatment with psychiatrist to treat your anxiety. It is not clear if you received any treatment (medication). For treatment drug therapy and cognitive behaviour therapy are used.
Amongst medical drugs used in treating anxiety - two types of medicine can be used.
1. For immediate relief of anxiety, benzodiazepines group of medicines are used (like clonazepam). They can be used for short term.
2. And for long term relief most commonly SSRI (selective serotonin reuptake inhibitors) are used. SSRI takes around 3-4 weeks to show its effect and cognitive behaviour therapy also takes weeks to show its effect.
Do not worry much. Your condition is very much treatable. 3-5% population same problem like you have. People get well within weeks after start of treatment. I recommend you to consult a competent psychiatrist who can guide you through your treatment.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards


Zoloft contain sertaline which is a SSRI and clonopin contain clonazepam is a benzodiazepine.
Usually during treatment when drug is not effective its doses need to be increase. Even sometime other medicine need to be added in the treatment after mental status and physical examination by psychiatrist.
If nightmare problem will also decrease with your anxiety symptoms.
If your thearpist want non drug treatment like CBT you can start it with drugs also. In my opinion you need concurrent drug treatment considering severity of symptoms.
I hope this information has been both informative and helpful for you.
Wish you good health.
Regards

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