a panic attack is the worst type of anxiety... it means that you haven t used proper coping mechanisms when the anxiety started as mild, then turned to moderate, then to severe, and lastly into panic attacks... your symptoms such as your chest pains and other referred pain may be the result of your anxiety. your body reacts to what you are feeling so your heart beats too fast, that makes your chest painful...(since it pumps faster and lesser oxygen-rich blood is circulated to the body) think of ways to deal with your anxiety, so that you will not get to the panic state...because if ur already in the panic state, the anxiety meds (anxiolytics) wont work unless you lessen the level of your anxiety back to severe, then to moderate...then if possible to mild... honestly, it is hard to do that..so people just try to pop anxiety meds.. xanax is a potent drug...(meaning its very effective) but if it worsens your condition, if you feel worse after taking it, then that s not the anxiolytic for you.. Diazepam (Valium) is a milder one....and yet effective unless you re not in the panic state... so i hope that answers your question....take the drug once you feel you are a bit anxious.. but the best way to manage that is through non-pharmacologic means... do some of your hobbies, make yourself busy talk to your friends, eat, cook, listen to music, enjoy yourself, dealing with anxiety varies from people to people.. you just have to know whats the best coping strategy for you.. thanks