Hi Karen,I used to get panic attacks in my late 20s--I'm now 52--and I never could put my finger on what caused them. Medication and psychotherapy helped them and I eventually learned to deal with them and then they basically went away. In general, I'm one of those people who always seems calm on the outside, so I think I'm more likely to internalize stress--whether it is caused by good things or bad. (You might want to read the article I posted today on stress.) I think many people say they aren't stressed because they aren't involved in a major bad event. But since I have many things that cause stress, my body finds all sorts of ways to let me know. The ear ringing still comes back sometimes, and that seems to be highly related to stressful moments like difficult phone calls or crisis with my parents. Between the meds and therapy now, I really have my life back along with no D. I really wonder why more people don't try anti-anxiety meds when other things have failed to control their D/C. If it works, then at least you can probably eliminate other sources for the problem and then decide how you want to handle the anxiety long term. For some, like me, that means medication for now though I am working on relaxation techniques and yoga. Both help me to slow down and calm down, but for now I also need the meds because the stress with my parents is ongoing and unpredictable. Sorry for such a long post. Take care.