The only cure for anxiety is, ultimately deconditioning.Meds definitely can help smoothen that process , but that needs to be addressed carefully, as PRN /SOS will reinforce the maladaptive conditioning. Ultimately the simplest analogy is to not respond to the false fire alarm - and the brain eventually stops treating it as emergency. Easier said than done , but that’s the hard facts. Most suffer from Somatic symptoms, but keep the noise peripheral, never central- by returning to whatever you are doing, however badly. As for anxiolytics- Fixed time dosing for a finite period prevents maladaptive conditioning and makes exposure therapeutic. Ultimately, for a panic attack emergency- creating a threshold rule is better, and even then hydroxyzine like antihistamines serve better than to messing with Benzos.

Agree. It’s radical exposure to the anxiety and trigger, and full acceptance of every feeling and symptom it brings, that’s the only true way out. The issue I myself encounter is that if one has built up enough anxiety over a long time, there is soo much to be processed, that the exposure and radical acceptance process requires a lot of time and deliberate action (even if action only means sitting with it). Possibly weeks or longer. Hard to find that time.

Maybe some people respond very well to hydroxyzine but it would not be typical for it to stop a panic attack. It is very mild.