First I just want to say thank you so much for creating this site. I am 23 years old, happily married, and we are expecting our first child this March. My whole life shifted at the end of last December when I had a very severe panic attack. I have had them on and off since I was 16, but was always able to calm myself down before this one. After 2 hours of not being able to calm down, I decided to go the emergency room. They gave me an Ativan, and sent me back home. 3 nights later, same feeling came back. I went back to the ER, (feeling like I was going to quit breathing at any minute). They did chest x-rays, EKG, everything was fine. They sent me back home. My mother, aunt, and grandmother all have Mitro-Valve Prolapse and have had similar symptoms, so I decided to visit her doctor to see if that was my answer. I made an appt, and sure enough it was confirmed. She did an EKG, but also a ultrasound on my heart to see the valve, as well as a treadmill exercise test . My resting heart rate was 134. I was a ball of adrenaline. To hear someone say they understood and to hear somewhat of an answer was such a relief. She prescribed me Lexapro for anxiety, as well as Atenalol (a beta blocker) to slow my heart rate down. I completely quit caffeine as well. For a few weeks things got better. The panic attacks slowed down, and I could tell my heart was not near as racy which was wonderful. No chest pains or tightness. I was still scared I would have another episode, but eventually got over that too. However, even after all this has been better, I started experiencing what I have came to learn is derealization. I am glad I found a name for it, because I cried myself to sleep several nights thinking something was terribly wrong with me. I had had this feeling in the past before each panic attack, but never been in what feels like a permanent state of it. I tapered off the lexapro, because I was certain it was causing it. It has got better, but still not fully away, and I have been off of it for several months now. I was switched to labetalol vs the atenalol for pregnancy. I don't believe the beta blocker causes it. I have researched and cant find anyone on that medication type with these symptoms. I think my panic attacks just traumatized me and I cant get out of this state. I don't talk with anyone about it because I feel like they wont understand. I feel like I cannot even fully enjoy my pregnancy because I feel this way most of the time. Its scary. & feels never ending. I also make it worse on myself because like you have mentioned I think about it 24/7. I wake up everyday and analyze how I feel. I haven't had an attack in a while, thank goodness, but just want to escape this feeling. It has probably been going on for about 7 months now. There are good days and bad days. It is more severe when I am by myself, or when I am driving. I just want to be my normal, outgoing, fearless self again, and feel like I have lost that. I don't even realize I am anxious or stressed. I just can't shake this feeling.