Therapy for Panic Disorder
When fear takes over without warning
A panic attack can seem to come out of nowhere.
Your heart starts pounding. You feel short of breath, dizzy, shaky, or disconnected from your surroundings. You may feel like you’re losing control, about to faint, or experiencing a medical emergency.
Even after the physical symptoms pass, the fear can remain.
Many people start therapy worried that another panic attack could happen without warning. Panic can be especially frightening when you don’t understand what is happening, don’t know what to do, or feel unable to make the sensations stop.
You may start paying close attention to every sensation in your body.
A faster heartbeat, a moment of dizziness, or a change in your breathing can make you wonder whether another attack is starting.
The fear of having a panic attack can begin to affect where you go, what you do, and how safe you feel. You may avoid certain places, activities, or situations because you’re worried about panicking. Instead of making choices based on what matters to you, you start making them based on what might help you prevent or escape another attack.
Over time, it can feel like panic has taken away your freedom, confidence, and sense of control.
Therapy can help you understand what happens during panic, change how you respond to the sensations of anxiety, and become more confident in your ability to handle them.
Fear does not have to determine where you go, what you do, or how you live your life.
What panic can feel like
During a panic attack, you might experience:
Because these sensations can feel intense and frightening, it makes sense that you would want to prevent them from happening again.
People often use the terms panic attack and anxiety attack to describe similar experiences, but there are some differences.
A panic attack is a sudden surge of intense fear or discomfort. Symptoms usually become severe within minutes and may include a pounding heart, shortness of breath, dizziness, shaking, sweating, chest discomfort, or fear of losing control or dying.
Panic attacks can seem to occur without warning. They can also be triggered by a feared situation, physical sensation, thought, or memory.
An anxiety attack is not a formal clinical diagnosis.
People commonly use the term to describe heightened anxiety in response to stress, worry, or something they believe might happen.
Unlike panic, anxiety may build more gradually and last longer. You might feel tense, restless, overwhelmed, unable to concentrate, or preoccupied with what could go wrong.
One way to think about the difference is:
Anxiety often builds around something you are worried might happen.
Panic is a sudden, intense alarm response that can make you feel like something terrible is happening right now.
Both can be distressing and interfere with your daily life. Understanding what you’re experiencing can help us figure out what may be triggering it and what might help.
When fear of panic begins to affect your life
Having a panic attack does not automatically mean you have panic disorder. Many people experience an isolated panic attack, particularly during stressful periods.
Panic disorder involves recurring panic attacks along with ongoing concern about having another attack or changes in what you do because you’re trying to prevent one.
You may begin:
These things can make you feel safer in the moment. But over time, they can also reinforce the idea that the sensations or situations really are dangerous.
How therapy can help
In therapy, we slow the experience down and look at what happens before, during, and after a panic attack.
Sometimes it begins with a physical sensation, such as a faster heartbeat, dizziness, or shortness of breath. You notice it and think something terrible may be happening.
That thought creates more fear. The fear makes the physical sensations stronger, which can make it seem even more likely that something is wrong.
The cycle may look like this:
Physical sensation → frightening interpretation → increased fear → stronger physical sensations → panic
Understanding this cycle can make panic feel less mysterious and help us see where we can begin to interrupt it.
The symptoms you experience during panic are real. In therapy, we look at what those sensations mean to you.
A pounding heart might lead to the thought, I’m having a heart attack.
Dizziness might become, I’m going to faint.
Feeling disconnected might mean, I’m losing control.
Using Cognitive Behavioral Therapy (CBT), we look at these thoughts and whether there may be another way to understand what your body is experiencing.
This isn’t about convincing yourself that nothing uncomfortable will happen. It’s about learning not to automatically treat every uncomfortable sensation as a sign that something is seriously wrong.
Avoiding something you’re afraid of can bring immediate relief. Checking your body, staying near an exit, or relying on another person may also make you feel safer in the moment.
The problem is that these strategies can keep you from learning that you can experience anxiety without the thing you fear actually happening.
Together, we look at the things you may be doing to prevent or escape panic and whether they might actually be keeping the fear going.
These behaviors make sense. You started doing them because you were trying to feel safe.
Once we understand how they are affecting you, we can gradually work on relying on them less.
An important part of CBT for panic disorder may involve exposure.
Exposure doesn’t mean forcing you to do something frightening before you’re ready. We work together and take things one step at a time.
We may practice experiencing some of the physical sensations you’ve become afraid of in a planned way. This is called interoceptive exposure.
For example, we may work with sensations such as a faster heartbeat, dizziness, or breathlessness. This gives you a chance to experience these sensations without immediately escaping them or trying to make them stop.
With practice, you can begin to learn that these sensations may be uncomfortable without necessarily being dangerous.
We may also gradually approach situations you’ve been avoiding.
When you’re afraid that panic could happen at any time, it can feel like you’ve lost control.
You may start believing that the only way to feel safe is to prevent the symptoms, avoid anything that might trigger them, or figure out how to make the panic stop.
In therapy, we work on a different kind of control.
You may not always be able to control how your body reacts, but you can learn to change how you respond to those sensations.
Instead of immediately assuming something is wrong, you learn to notice what’s happening and understand it for what it is. You can make choices about what to do next, even when you’re uncomfortable.
Over time, it is possible to become less afraid of the sensations themselves and more confident that you can handle them when they happen.
You don’t have to know exactly what your body is going to do in order to trust that you can handle what comes next.
Panic may have changed what you feel comfortable doing.
Maybe you’ve stopped driving alone, exercising, traveling, attending events, spending time by yourself, or going to crowded places.
Or maybe you still do these things, but only if you know where the exits are, have someone with you, or have a plan for what you’ll do if you panic.
Together, we look at what you want to be able to do again and take manageable steps toward doing it.
You don’t have to wait until you feel completely free of anxiety to start getting back to the things that matter to you.
Therapy can help you:
How I can help
I’m Dr. Vanessa Gomes, a licensed psychologist and Beck Institute-certified CBT therapist.
I use evidence-based CBT to help you understand what happens when you panic and identify the patterns that may be keeping the fear going.
We look at how panic is affecting your life and decide together what we need to work on.
You don’t have to face everything at once. We take things step by step as you learn to respond differently to panic and become more confident in your ability to handle it.
There’s usually no single cause. Stress, family history, big life changes, and the way your body responds to fear can all contribute to panic attacks. Some people notice clear things that trigger panic attacks, like a crowded store or a faster heartbeat. Others have unexpected panic attacks that seem to come out of nowhere.
You don’t need to pinpoint the onset of panic attacks before therapy can help. We can start with what’s happening now: the situations you’ve started avoiding and what you tell yourself when the sensations show up.
Panic attacks are sudden, and most peak within about 10 minutes. Attacks typically ease within 20 to 30 minutes, even though it can feel much longer while it’s happening. Some people have several attacks close together, which can make it seem like one long episode.
Common symptoms include a rapid heart rate, shortness of breath, chest discomfort, dizziness, and starting to sweat or tremble. Many people describe intense episodes of fear or discomfort, a sense of loss of control, or a fear of dying. These symptoms of panic attacks are real, and they can feel overwhelming in the moment.
The fear and anxiety afterward often last longer than the attack itself. If your symptoms are new, severe, or don’t feel like your usual panic, it’s important to seek care from a health care professional instead of assuming they’ll pass.
Nocturnal panic attacks wake you up from sleep with a pounding heart, sweating, shaking, or trouble breathing. Panic attacks can occur at night with no clear trigger, and waking up in the middle of one can be especially confusing and frightening.
Sleep disorders and other health conditions can cause similar symptoms, so it’s worth talking with your doctor about nighttime episodes. If panic is part of the picture, therapy can help reduce panic around bedtime and the worry that it will happen again.
Some people do have panic attacks every day. Panic attacks often cluster during stressful periods. Frequent attacks can be part of panic disorder, which is an anxiety disorder, but how often they happen doesn’t confirm a diagnosis on its own.
What matters just as much is the frequency and intensity of the attacks and how panic is affecting your life. How much time are you spending waiting for the next one? What have you stopped doing because of it? If severe panic, or the fear of it, is changing how you live, it’s worth getting an assessment.
Yes. CBT is one of the most well-researched and effective treatment options for panic attacks and panic disorder, and it’s the type of therapy I use. Progress looks different for everyone. Together, we look at whether you’re responding to panic differently and getting back to the things you want to do.
CBT focuses on identifying the thoughts and behaviors that contribute to the panic cycle. Together, we identify and challenge negative thought patterns, like reading a racing heart as a sign of danger, and practice responding differently. Over time, CBT can help you manage panic attacks effectively, reduce the intensity of each one, and reduce the fear of the next one, so you feel more in control of your day.
It also matters that you feel comfortable with your therapist. You can ask me questions about the approach at any point and tell me when something feels confusing, too hard, or isn’t helping.
It’s a good idea to ask panic disorder therapists what kind of therapy they use, how it’s tailored to your needs, and how you’ll know if it’s working. You can also ask whether exposure therapy is part of the approach and how you’d decide together when to start.
You might hear terms like cognitive restructuring, which means looking at a thought and considering another way to understand it. You can always ask me to explain things in everyday language. Part of my job is to help you learn how what we talk about in sessions connects to what happens when you panic.
There’s no set number of therapy sessions for panic disorder. Your treatment plan is personalized, so it depends on your goals, what’s been happening, and how things change as we work together. Most people start with weekly sessions, and we can talk about what frequency makes sense for you.
Each week, I ask for your feedback and we look at what has changed since the last session. That includes what helped between appointments and what still feels hard, so the work stays connected to your everyday life. Over time, therapy helps you develop skills you can use on your own as you reach your goals and regain a sense of control.
If therapy hasn’t helped before, I want to understand what you tried and what still feels hard. Did you learn about panic but still not know what to do when it happened? Did the fear of another attack keep shaping your decisions?
Those details help us figure out what you need now. If overthinking keeps you replaying each episode or searching for certainty, we can work on that too. And if something isn’t working while we meet, I want to hear about it so we can adjust.
Yes. Many people with panic also live with depression, trauma, or other anxiety concerns. CBT is used to treat all of these, including panic attacks. That doesn’t mean every panic attack comes from trauma, or that you need one explanation for everything you’re feeling.
I also help adults with depression and trauma. Together, we look at how these concerns are affecting your day and decide what needs attention first, while keeping your goals for panic clear.
Yes. Therapy and medication can both be part of treatment for panic attacks and your broader mental health care, depending on your needs and health history. I don’t prescribe medication, so medication decisions are made with a psychiatrist or another prescribing provider.
With your permission and a signed release of information, I’m happy to collaborate with your psychiatrist. That way, your providers can share what’s relevant while you stay involved in decisions about your care.
Coping skills can help you get through a hard moment. In therapy, you can learn coping skills like breathing exercises such as slow, deep breathing, along with grounding techniques, mindfulness techniques, and progressive muscle relaxation. These are relaxation techniques to help your body settle when anxiety and panic start to build.
The question is whether your coping strategies are helping you stay in your life, or becoming something you feel you have to do before you can go anywhere or handle a physical sensation. Together, we look at how you’re using coping skills alongside avoidance and safety behaviors. Not every way you comfort yourself needs to change. The goal is to respond to panic with more flexibility, rather than trying to make every sensation stop.
Yes. I offer virtual therapy for adults anywhere in New York State, including people struggling with panic attacks. Virtual therapy sessions take place on a secure video platform, which can help when panic has made it hard to leave the house or get to the office.
All you need is a quiet, private space where you can talk without interruptions. Together, we can decide whether online or in-person sessions fit you best.
Yes. I offer in-person sessions at my office in Port Jefferson, near the Port Jefferson LIRR station, in the building with the pillars. It’s an easy option if you’re looking for a panic attack therapist in Port Jefferson, and many people also come from nearby Port Jefferson Station, Stony Brook, and Setauket.
Bus route 62 stops at N Country Rd and Oakland Ave, route 51 stops at the Port Jefferson LIRR station, and there’s plenty of parking right by the building. If getting to the office feels hard right now, online sessions are available across New York State.
I accept Aetna. For other insurance plans, I’m an out-of-network provider, and I can give you a superbill to submit to your insurance company for possible reimbursement. It’s a good idea to call your insurance company first to check your out-of-network mental health benefits. A Good Faith Estimate is also available on request.
Taking the Next Step
In-person therapy in Port Jefferson and online therapy throughout New York State.
Important: Panic symptoms can resemble symptoms caused by physical health conditions. New, severe, or unexplained symptoms should be evaluated by a medical professional rather than automatically assumed to be anxiety or panic.
Please note — The only insurance I accept is Aetna and my rate is $250/session.
