Panic Attack Treatment
Terrifying, Convincing, and Treatable
Few experiences are as frightening as a panic attack.
One moment you’re going about your day, and the next something changes.
An overwhelming conviction takes hold that something is terribly wrong.
Oh my God, something is wrong.
Why is my heart doing this?
Why can’t I breathe?
What is happening to me?
Your heart is pounding. Your breathing feels fast and out of control. Your body starts shaking. You might feel dizzy, disconnected from yourself, disconnected from your surroundings, or suddenly unsure of what feels real.
And because all of this is happening at once and out of the blue, a panic attack can feel like an emergency.
Many people are convinced they’re having a heart attack. Others worry they’re going to pass out, lose control, or lose their mind. The experience feels that real.
The terror is real. The physical sensations are real.
Let’s talk about what they mean.
What Happens During a Panic Attack
One of the most confusing things about panic attacks is that they often seem to come out of nowhere.
You could be driving, shopping, sitting in a meeting, lying in bed, watching television, or doing something you’ve done hundreds of times before.
Then suddenly your nervous system reacts as though you’ve encountered a life-threatening emergency.
A panic attack is not a failure of your body’s alarm system.
It’s a false alarm from an alarm system that is working exactly as it was designed to work.
Your heart beats faster. Your breathing changes. Adrenaline enters your system. Your body prepares to fight, flee, or survive.
The problem is that your body is responding to an emergency that isn’t actually happening.
That distinction can be very difficult to believe while you’re in the middle of a panic attack. Everything happening inside you is sending the same urgent message: Something is wrong. Do something now.
Some of the most frightening symptoms involve feeling detached from yourself or your surroundings. People describe feeling unreal, dreamlike, disconnected, or as though they’re observing themselves from outside their own experience. The world around them can suddenly look strange or unfamiliar.
When you don’t know why that is happening, it’s easy to interpret the experience as evidence that something is seriously wrong.
These experiences can occur during panic and intense anxiety.
Understanding what is happening doesn’t instantly stop the symptoms, but it can change how you respond to them.
The Fear of the Fear
As frightening as panic attacks are, the attack itself is often only part of the problem.
What happens afterward can start changing how you live.
You pay closer attention to your body. An unusual sensation gets your attention immediately. You worry another panic attack is coming.
You may become hesitant about driving, traveling, exercising, sitting in crowded places, being far from home, or being somewhere without the person who helps you feel safe. Situations that once felt ordinary can feel very different when you’re imagining what it would be like to have a panic attack there.
It makes sense that your brain would want to protect you from another terrifying experience.
It can feel like immediate relief to avoid potential panic attack situations. You leave, seek reassurance, or avoid the situation altogether, and the panic – and the immediacy of the next panic attack – eases.
That’s when panic begins making the decisions in your life.
Over time, panic attacks become more about the fear and avoidance of experiencing those symptoms again.
Learning to Respond Differently
The goal of panic treatment isn’t to guarantee that you’ll never experience panic attacks again.
I want you to understand what is happening to you well enough that those sensations don’t need to mean emergency. And I want you to know what to do when a panic attack happens.
Panic feels extraordinarily powerful, but it’s also very treatable. There are specific things we can work on that can change both how you respond during a panic attack and how much of your life gets organized around preventing the next one.
We’ll look at what happens when a physical sensation gets interpreted as danger, how that interpretation can create even more alarm, and how the cycle builds from there.
I like clients to understand why the things we’re doing can help. We can work on ways of responding to the thoughts, physical sensations, and urges that come with panic while also helping you become more familiar with what your nervous system is doing.
Over time, the aim is to build confidence in your ability to recognize panic and know how to respond when it happens.
Taking Your Life Back
Panic can influence your life even after the panic attack itself is over.
You take a different route because the thought of having a panic attack while you’re stuck in traffic feels unbearable. You sit near the exit. You stop exercising because a pounding heart feels too much like the beginning of an attack. Trips, restaurants, crowded events, even ordinary errands start coming with the same question: What if I have one there?
The world can gradually get smaller when more and more decisions are organized around preventing another panic attack.
Part of our work is understanding that the sensations of panic do not have to mean what they once seemed to mean.
Panic attacks are terrifying and convincing. They are also understandable and treatable.
Uncomfortable and dangerous are not the same thing.
The aim isn’t to organize your life around making sure panic can never happen again. It’s to help you get your choices back when panic tries to make them for you.
Get started here
Complete the secure inquiry form below and I’ll personally respond within one business day. We’ll schedule a brief consultation call where you can share a general sense of what brings you to therapy, ask questions about my approach, and decide whether working together feels right for you.
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Licensed Professional Counselor
Cheryl Zandt
Telehealth Counseling in Washington DC and Virginia
Cheryl Zandt is a Licensed Professional Counselor providing online therapy for women in Virginia and Washington, DC. For more than 20 years, she has helped women face anxiety, burnout, panic, relationship challenges, and life transitions with greater understanding, self-trust, and choice.
Thoughtful, collaborative, and grounded in research, curiosity, and genuine human connection, her approach helps clients make sense of experiences that have felt confusing, frustrating, or overwhelming for far too long.
Your questions, answered
How do I know if I'm having a panic attack and not a heart attack?
Panic attacks and certain medical conditions can share some symptoms, which is one reason panic attacks are so frightening. If you’ve never experienced symptoms like these before, it’s important to consult a medical professional. Once medical causes have been ruled out, many people find relief in understanding how panic affects the body and why the symptoms can feel so convincing.
Why do panic attacks seem to come out of nowhere?
Panic attacks often feel sudden because the nervous system reacts much faster than conscious thought. Many people are surprised by how quickly panic can escalate. One reason therapy can be so helpful is that it provides a clearer understanding of what’s happening in your mind and body during those moments.
What are depersonalization and derealization?
These are common experiences during panic attacks and intense anxiety. Depersonalization can feel like you’re disconnected from yourself or observing yourself from the outside. Derealization can make your surroundings seem unreal, dreamlike, or unfamiliar. Although these sensations can be deeply unsettling, they are recognized features of panic and anxiety.
Can panic attacks make you feel like you're losing your mind?
Yes. Many people experiencing panic attacks worry that they’re losing control, “going crazy,” or having some kind of mental breakdown. These fears are extremely common during panic attacks. While panic can feel overwhelming, panic attacks themselves do not cause people to lose touch with reality or lose their minds.
Why am I afraid of having another panic attack?
Panic attacks are frightening enough that many people begin worrying about when the next one might happen. Over time, the fear of experiencing another panic attack can become more disruptive than the panic attacks themselves. This is a common part of panic disorder and one of the reasons treatment can be so effective.