If you’re like Jill, is there any treatment that can help?

Yes, there is. Individuals with this condition are successfully treated with an antidepressant such as serotonin-reuptake inhibitors. Usually, dose should be started low, for instance 10 mg/day of citalopram. After a few weeks, dose should be gradually increased depending upon person’s clinical status.

Cognitive behavior therapy is likewise very effective. This type of “talk psychotherapy” helps individual to restructure his or her thinking. Negative cognition associated with illness should be addressed in therapy because it creates more harm than good. Relaxation techniques such as breathing exercises should also help.

During treatment, patience is very important because it takes a while before any intervention helps. However, don’t despair. After a few weeks, medication should start working and should give you a feeling of comfort.

What’s role of benzodiazepines (e.g. lorazepam or clonazepam) in treatment of panic disorder? This type of drug can provide acute relief but should be used only on a short-term basis because of its addiction potential. For long-term treatment, antidepressants and psychotherapy are still preferable.

Copyright © 2005. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: An Emotional Intelligence or EQ Game. For more information, please visit www.oikosgame.com and www.soardime.com

Tell truth. Be kind. A little goes a long way. Speak carefully. Emphasize positive. Say good things, especially to yourself. Be aware of your effect on others. Don't assume you're being understood—check it out. When you realize you've made a mistake, apologize, face to face if possible so you can look other person in eye. Don't interrupt. Don't give advice unless you're asked. Don't gossip. It wastes time you could be using to empower yourself. Choose your battles. If someone gets angry at you, stop doing whatever triggers them no matter how right you think you are, until you can find a better way to communicate. Why make yourself a target? Know when to shut up or decline to answer. Watch what you listen to. Don't dismiss different points of view. Pay attention not only to what someone says—try to understand why they're saying it. Don't put up with disrespect, manipulation or negative thinking from anyone, including yourself.

6. DON'T KEEP SCORE Setting your own standards

Life isn't about success or failure. Although both teach valuable lessons, fulfilling your potential is essential goal. Adversity can develop strength. If a dream sours, let it go without judgment or remorse. Assume it's no longer relevant, and look for new options. Even a losing battle can be a stepping-stone to a better situation. Accepting change brings peace of mind.

7. NO VICTIMS, NO VILLAINS Every situation brings exactly what you need to wake up

Relationships are like jigsaw puzzles. All pieces fit together to create whole. You are not responsible for anyone else, nor are they for you. There's no guilt, no blame, no shame. Allow things to be as they are. Accept each moment as if you'd chosen it. If someone hurts you, look for what you can learn from it. Holding a grudge drains your energy. Forgiveness doesn't mean it was okay with you; it means releasing person's power to upset you. You may never forget, but letting go of resentment is more productive. This goes double for forgiving yourself.

8. MEDITATE AND TREAT YOURSELF WELL Nurture yourself

Make time to have fun and enjoy life. Take walks in nature. Spend time alone. Exercise, rest and eat when you need to, and drink lots of water. Something as simple as a warm bath or good stretch can do wonders in improving your perspective. Laugh. Let yourself dream your fondest dreams. Celebrate your successes, big and small. Meditation calms your conscious thinking mind, and helps you access your inner wisdom. Counting your breaths is basic form, or you can silently repeat a soothing word or phrase like "peace" or "well-being." When your mind wanders, and it will, just bring your focus back and start over. Even ten minutes a day can make a difference.

9. GET OUTSIDE HELP See beyond your blind spots

Get counseling. It helps to talk about your feelings, no matter how embarrassing, strange or awful they seem to you. Find someone you trust and feel compatible with, and be willing to pour your heart out. An objective outsider can clear up confusion and help you set your creative energy free. Examine both sides of any issue. Don't follow advice blindly, but do explore ideas that make sense to you to see what happens. Join a group of people with similar interests or circumstances to yours. Try art, sports, music, or dance for fun and/or therapy. Read self-help books. Most have at least some helpful nuggets, and can reassure you that you're not alone. Don't expect The Answer, but serve yourself a variety of ideas to take or leave as you like.

10. MOVE ON Graduate to living fully

Respect your own boundaries. Your first commitment should be to yourself and to learning as much as possible from what happens to you. Only when you're at peace with yourself can you make a real contribution to anyone. Live your own truth, be honorable, and intend best for everyone, including yourself. Trying to change someone is futile, no matter how much you care, or how badly you think they need it. You have no control over what anyone else feels or thinks. Do what you can, and do your best, but not at your own expense. Working things through can be healing when there's mutual respect, but if you feel hopeless, scapegoated, threatened or frantic, retreat may be only appropriate choice, at least for moment. It could be as basic as leaving room briefly, or as extreme as ending relationship or moving away. But be open to possibility that "problem" person may surprise you. Your changes alter context of relationship, so eventually they may come to treat you differently. If so, you may want to renew relationship, but don't rush into it until you're confident that things have changed. To leave your mark on future generations, pass along what you learn.

I wish you healing, faith and courage to make your dreams come true.

You have permission to publish this article electronically or in print, free of charge, as long as it is kept intact, including brief bio, website information, and this copyright line: (c)2005 Suzanne Gold. A courtesy copy of your publication would be appreciated.