instruction: hello doctor I suffered from a horrible panic attack this morning which lasted over hours and along with it I got painful cramps in my stomach similar to contraction pains and really bad chest pains it felt like someone has physically squeezed my heart and I have seen my doctor about this previously although my anxiety has not been this bad before but I am not sure what to do I have tried so many different medications and none have helped except valium and oxazipam but my doctor does not want to prescribe it because it is addictive and I do not know what to do because as I said my anxiety is debilitating now and I am a young mother of two I need to be able to look after them this morning I had to get my mother over here to look after them because of how bad my anxiety was worst part is I do not know why I had a panic attack in the first place
output: hello I understand that high levels of anxiety and panic attacks can be debilitating and needs to be properly managed your doctor is correct in informing you that valium and oxazepam are not appropriate in this situation as they will make the situation worse if anxiety is persistent discuss with your doctor about trying saris or saris type of medication you have mentioned about trying different medication before there are different options like fluoxetine sertraline escitalopram etc based on your assessment and tolerability your doctor can prescribe appropriate medication and dosage try jacobson progressive muscle relaxation exercise atleast once daily to help to manage stress levels avoid caffeinated drinks alcohol and other drugs which can worsen panic symptoms finally consider having cut therapy counselling which is known to be effective in managing anxiety and panic attacks