I am using rivotril 0.5 mg since 2011. Now I have panic attack. And always some fear. I can't go any place lonely. A fear is if I die along. nowadays I get suddenly fear and my heart palpitation is high. What can I do in this situation. Medicine or psychologist I should contact.

Dr. Prof. Jagadeesan M.S.Psychiatrist17yrs exp

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Rivtotril for panic attacks is like paracetamol for fever. It reduces the symptoms but does not act on the cause, which is reduced serotonin levels. A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you are losing control, having a heart attack or even dying. Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder. Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective. Consult any psychiatrist online or in person and get remedy. All the best for you.  

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Mr. Saul PereiraPsychologist50yrs exp

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If it is too much for you to handle, you can use medicine along with therapy. These sound like panic attacks. Panic attacks are fear based, and you will tend to exaggerate the response to the normal stimulus. The other possibility is that your constitution may have undergone a bit of change favoring the negative side. If you have been on prolonged stress quite unaware to yourself, then it is possible that that stress may have lowered your defenses. Any which way you look at it, your response to fear is not normal and therefore the panic. Work with a counselor: medication is not enough to help you process these emotions and to deal with it so that it does not escalate in this manner. You will probably not show any signs of medical problems because the effects have not yet reached physical proportions. It will though, if this situation is not brought under control. The quicker you work on this in therapy, the easier life is going to be. Constant and persistent stress will lower your immune system that you may develop other complications. You seem keen to sort this out and that is good motivation. Now work at it with hammer and tongs and sort out the fear. For your constitution I advise a lot of exercise, meditation, eat healthily, sleep adequately, pray with faith, love people and yourself, live stress-free, and be positive. 

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Ms. Rachna MishraPsychologist9yrs exp

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Managing anxiety 1. Yoga and meditation can help cope with anxiety. Simultaneously learn deep breathing techniques. You might think these techniques are ?old school? or ?uncool? but please practise these techniques regularly and with discipline, and we assure you it will help you significantly. 2. Mindfulness - mindfulness is the practise of being present in the moment. It is the practise of observing what your feelings are and accepting them without judgement. For example, when you are feeling anxious - mindfulness is the process of noticing and accepting the anxiousness. Make this a habit and it will help you relax. 3. Getting involved in social work is helpful as it connects you to people, helps you to develop self-esteem and breaks the chain of stressful thoughts. It will also help you get more perspective and realise how fortunate you are - it will help you feel more positive and help you get rid of negativity. 4. Soothing music can also help lower anxiety levels, and so can watching comedy shows. 5. While social media helps you connect with people, late nights spent on social media deprive you of sleep which may raise anxiety levels. Constantly checking social media for ?likes? or for ?last seen? can also have a significant effect on anxiety. So ensure that you are disciplined enough to keep a watch on the same. 6. Train your mind to cope with unnecessary anxiety. Develop a positive attitude and accept that your achievements will at times lag behind your ambitions. 7. Work to get quick wins - look to improve on yourself 1% a day, everyday and while there will be ups and downs in the journey - you will soon be a much better and confident version of yourself. 8. Find your calling - find your passion and your calling and be completely invested in it - you are much more likely to find excellence and then success will come calling (a very powerful quote from our favourite rancho from 3 idiots). You will feel much happier and confident when you are the best and the most successful version of you. 9. Getting regular and sound sleep, eating a balanced diet, connecting with people (as opposed to staying isolated) can help in managing anxiety. 10. Adding supplements to your diet can help reduce anxiety. Some useful supplements are green tea, chamomile tea, kava kava, ashwagandha, vitamin b6, omega-3, iron. Reduction of alcohol and caffeine consumption is also helpful. 11. If nothing else works well enough, consult a doctor for counselling / medications. But medications can cause serious side effects ? use them only for short term. 

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