2nd – I have had panic disorder for 32 years, and take both an antidepressant for the symptoms and ativan (better than xanax IMHO)

3rd – I will likely need to take these meds for the rest of my life. Works for me. Call me dependent if you’d like, but it’s a genetic tendency in my family and I’m completely functional on my meds. Whatever works, whatever it takes – (if you had diabetes would you not take insulin just because people might call you dependent?)

4th – take whatever xanax you need to restabilize yourself. Refrain from calling your doctor a moron – you never know when you may need her help and she is after all, a DOCTOR.

5th – you will not experience withdrawal from one dose of xanax. I don’t understand why you hesitate to take it more frequently. What I do is take my ativan in the evening. The immediate effect helps me sleep at night and the residual effect lets me be alert but calm the next day without the drowsy effect. I take it every night wether I’m anxious or not. This therapy mode has been endorsed by two excellent doctors. It works, try it. The goal is PREVENTION of attacks, not treating them.

6th – There are two components to panic disorder. One is the actual panic attack itself, but the other is "anticipatory anxiety", which can lead to an attack. Your xanax is an important part of treating the anticipatory anxiety, while the antidepressant controls the fight/flight panic symptoms. Use both modalities, they are meant to be used together.

7th – know that no matter how excruciating the full blown panic attack feels, it will not kill you – you will NOT die – if it was going to kill you, it would have happened already. The best thing you can do is to recognize it, ACCEPT what it is happening, and let it wash over you. DO NOT FIGHT IT. Remember it has happened before and you did not die then and you won’t die know. This technique will lessen the duration of the episode. You already know the panic will eventually pass. What I do is get up and keep moving. My rational is if I can keep moving, I am in no danger of dying – dying people can’t move. Also, movement helps burn off the excess adrenaline I’m producing, using the "flight" part of the reaction, working with my body. Remember also to breathe in thru the nose slowly, deep down expanding your stomach, not the chest, letting the air out slowly through the mouth. If you feel sweaty, stand in front of a fan – if you feel cold, turn up the heat – take charge of the panic without fighting it.
References :
I am a RN with a 37 year history of panic disorder.