Introduction to the Anxiety Series
At LightLine Therapy, we meet many people who describe feeling trapped by their anxiety. Some experience it as constant worry. Others experience it as sudden, intense panic that seems to come out of nowhere. Sometimes they know exactly what triggered it. Other times, it’s not as obvious. This is where therapy for panic disorder comes into play.
This post is part of our ongoing anxiety series where we break down the most common forms of anxiety and how therapy helps. In Part 1, we explored generalized anxiety disorder—the steady, ongoing hum of worry. Here in Part 2, we’ll look at panic disorder, a condition that can strike suddenly and leave people feeling scared of their own bodies.
Understanding Panic Disorder
Panic disorder involves repeated, unexpected panic attacks. These usually resemble sudden waves of fear that peak within minutes and then deescalate, but are extremely uncomfortable and even painful. People often describe feeling like they’re losing control, “going crazy,” or even dying.
According to the National Institute of Mental Health, about 4.7% of U.S. adults will experience panic disorder at some point in their lives. It’s more common than many realize and can affect anyone, regardless of how composed they seem on the outside.
Therapy for panic disorder helps people understand what’s happening in their minds and bodies during these moments, breaking the cycle of fear that panic attacks often create.
What Does Panic Disorder Feels Like?
A panic attack can feel like your body is sounding an alarm for no reason. Even if you know you’re safe, your heart races, your chest tightens, and breathing becomes shallow. You might feel dizzy, detached, or convinced something terrible is happening.
Common physical symptoms include:
- Pounding or rapid heartbeat
- Shortness of breath or choking sensation
- Chest pain or pressure
- Dizziness or nausea
- Trembling, sweating, or chills
Emotional symptoms often include:
- Fear of losing control or “going crazy”
- Feeling detached from reality (derealization)
- A strong sense of dread or impending doom
After a panic attack, people often fear having another. That fear alone can trigger more attacks, creating a vicious loop of anticipation and avoidance.
What Causes Panic Disorder?
Similar to Generalized Anxiety Disorder, there isn’t a single cause of panic disorder. It usually develops from a mix of biological, psychological, and environmental factors.
Contributors can include:
- Genetics: Family history of anxiety or panic increases risk.
- Stressful life events: Loss, transitions, or trauma can sensitize the nervous system.
- Personality factors: Individuals who are highly sensitive or perfectionistic may be more prone.
- Body sensitivity: Some people are more reactive to physical sensations like increased heart rate or dizziness.
Research from the American Psychological Association notes that people with panic disorder often misinterpret normal bodily sensations as dangerous. For example, a racing heart after climbing stairs might trigger a full panic response because it feels similar to a previous attack.
Understanding this connection between body and mind is a key part of therapy.
Panic Attacks vs. Panic Disorder
A panic attack is a sudden, intense surge of fear that peaks within minutes. Panic disorder, on the other hand, is a mental health condition marked by recurring, unexpected panic attacks and a lasting fear of having more. In short, panic attacks are the symptoms, while panic disorder is the diagnosis that includes those repeated attacks (along with the anxiety and behavioral changes that develop in response).
| Panic Attack | Panic Disorder |
|---|---|
| Can happen once or occasionally | Involves repeated, unexpected attacks |
| Often linked to a stressful event | Attacks seem to appear “out of nowhere” |
| Fear usually fades after it’s over | Ongoing fear of future attacks develops |
| May not interfere with daily life | Can lead to avoidance and major life disruption |
If you’ve had a few panic attacks but aren’t living in fear of the next one, it might not be panic disorder. The difference lies in how much the fear starts to shape your behavior.
What Is Therapy for Panic Disorder?
The goal of therapy for panic disorder isn’t to eliminate all panic sensations but to change how you respond to them. Therapy helps you retrain your brain and body to interpret physical sensations more accurately, breaking the cycle of fear and avoidance.
Here are several approaches that have proven effective, both in research and from our own experiences treating panic disorder:
1. Cognitive Behavioral Therapy (CBT)
CBT is the most well-researched treatment for panic disorder. It helps you identify catastrophic thoughts (“I’m dying,” “I can’t breathe”) and test them against reality. Through gradual exposure to feared sensations, like increased heart rate or breathlessness, you learn that discomfort doesn’t equal danger.
2. Psychodynamic Therapy
Psychodynamic therapy looks beneath the surface. It helps uncover underlying emotional conflicts, early experiences, or internal pressures that contribute to panic. Some clients discover that panic attacks show up when they suppress anger, grief, or fear for too long.
Understanding these hidden emotional drivers creates lasting change rather than short-term symptom relief.
Explore how LightLine uses Psychodynamic Therapy in NYC.
3. Exposure-Based and Interoceptive Therapies
These approaches gently help clients face feared sensations or situations (like racing heartbeats or crowded spaces) so they can learn their bodies are not the enemy. Over time, exposure therapy rewires the nervous system’s response, teaching it that these sensations aren’t signs of danger.
4. Mindfulness-Based Approaches
Mindfulness helps you observe panic symptoms with curiosity instead of panic about panic. By practicing present-moment awareness, you train your brain to stay calm during body sensations that once felt unbearable.
5. EMDR (Eye Movement Desensitization and Reprocessing)
For clients whose panic disorder stems from trauma or overwhelming experiences, EMDR can be especially helpful. It helps reprocess those memories so they no longer activate the same physiological fear response.
What Does Therapy for Panic Disorder Actually Look Like?
Therapy is collaborative and it starts with understanding how panic disorder shows up for you. Sessions often focus on:
- Education: Understanding what panic is and how your body reacts.
- Awareness: Identifying triggers and early warning signs.
- Reframing: Challenging catastrophic interpretations of body sensations.
- Exposure: Gradually confronting feared sensations or situations.
- Regulation: Learning breathing and grounding techniques to calm the body.
The goal isn’t to avoid panic, but to reduce the power it has over your life. Explore more forms of LightLine’s Anxiety Therapy in NYC.
How to Manage Panic Between Therapy Sessions?
Therapy provides the roadmap, but daily practice solidifies progress. There are small, practical steps that we usually practice in sessions but they’ll only return solid results if you use them outside of the office (or Zoom room).
They include things like:
- Breathing exercises: Slow, deep breathing helps regulate the body’s alarm system.
- Grounding techniques: Focus on sensory details (texture of a chair, sound of your breath) to stay present.
- Movement: Gentle exercise helps release excess adrenaline.
- Reduce stimulants: Limiting caffeine or nicotine can prevent false alarm responses.
- Keep a log: Noting when panic arises can reveal triggers and patterns.
For some people, medication prescribed by a psychiatrist can help reduce the intensity of physical symptoms, creating more space to use the tools learned in therapy. It doesn’t replace therapy, but when used thoughtfully, it can make the work more manageable and effective.
When to Seek Therapy for Panic Disorder
Consider reaching out for therapy if:
- You’ve had multiple panic attacks that seem to come “out of nowhere.”
- You live in fear of the next attack.
- You’ve started avoiding places or situations because of panic.
- The physical symptoms interfere with sleep, work, or relationships.
Panic disorder is highly treatable, and most people see meaningful improvement once they start therapy. You don’t have to wait for things to get worse or for your life to shrink around the fear of another attack. Getting help early means giving yourself the chance to rebuild confidence, trust your body again, and feel safe in your own life.
Conclusion
Therapy for panic disorder helps people transform fear into understanding. It teaches you that panic, while terrifying, is not dangerous and that your body is capable of returning to calm.
At LightLine Therapy in New York City, we work with clients who are tired of living in fear of the next panic attack. Our goal is to help you rebuild trust in your body and regain a sense of safety in your own mind.
You don’t have to keep waiting for the next panic attack to hit. You can start learning how to stop it from controlling your life.
Reach out to schedule a consultation today.
FAQs
1. How does therapy for panic disorder work?
Therapy focuses on changing how you interpret and respond to panic sensations. You’ll learn to recognize early signs, challenge catastrophic thoughts, and use grounding skills to reduce intensity. Over time, your body learns that panic isn’t dangerous, and attacks become less frequent and less severe.
2. How long does it take to feel better from panic disorder therapy?
Of course, it’s hard to put a number on this. Some people notice improvement within a few weeks, especially when they practice between sessions. For those with more severe symptoms, it will likely take longer. Full recovery varies based on factors like severity and duration of symptoms, but most people experience lasting relief within several months.
3. Can panic disorder be treated without medication?
Yes, many clients successfully manage panic disorder through therapy alone, especially CBT or exposure-based approaches. However, some choose to combine therapy with medication prescribed by a psychiatrist to help regulate physical symptoms while therapeutic work progresses. Think of medication like a tool. It’s there if you want it and might make things easier, but it’s not necessary.
4. What’s the difference between panic disorder and generalized anxiety disorder?
While GAD involves ongoing, low-level worry, panic disorder centers on sudden, intense episodes of fear. The physical symptoms of panic attacks like a racing heart, chest pain, and shortness of breath, are much more acute. Some people experience both, but therapy can target each pattern differently.
5. What if I’m afraid of having a panic attack during therapy?
That fear is not uncommon. A good therapist will move at your pace and teach regulation tools before exploring panic triggers. You’ll never be pushed into something unsafe. The goal is to build safety and confidence so that even if panic arises, you’ll know how to manage it effectively.
