Panic Disorder

When the alarm fires without a cause.

Panic attacks themselves are not dangerous, but the fear of the next one is what drives the disorder. Panic disorder is highly treatable. The right combination of medication and behavioral work produces durable change for most patients.

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Understanding

Understanding panic disorder

A panic attack is a sudden surge of intense fear or discomfort accompanied by physical symptoms. Racing heart, shortness of breath, dizziness, chest tightness, derealization. Panic attacks themselves are not dangerous, but the fear of the next attack is what drives the disorder. Many people develop avoidance. Of public spaces, driving, exercise, or anything that might trigger an attack. Which gradually shrinks the world.

Panic disorder is highly treatable. Effective care addresses both the underlying physiology (with medication) and the conditioned avoidance (with exposure-based therapy). The combination produces the most durable results.

Signs

Recognizing the signs

Sudden, unexpected episodes of intense fear or discomfort
Physical symptoms: racing heart, shortness of breath, sweating, trembling, chest pain
Sense of unreality or detachment during attacks
Persistent worry about having another attack
Avoidance of places or situations where attacks have occurred
Repeated emergency-department visits with negative cardiac workups
Symptoms persisting for more than a month

Treatment

How we treat it

Panic disorder treatment at Feel August begins with confirming the diagnosis and ensuring that medical causes (cardiac, thyroid, vestibular) have been appropriately ruled out. Your clinician will ask about the texture of your attacks, what triggers them, what you have tried, and what you avoid.

Medication options include SSRIs and SNRIs as first-line treatment, with short-term, time-limited use of benzodiazepines reserved for specific clinical situations. We coordinate with cognitive behavioral therapists trained in panic-focused exposure work, since the combination of medication and behavioral therapy outperforms either alone. We track PDSS or panic-attack frequency at each visit.

First visit

What the first conversation looks like

Your first appointment is sixty minutes. Come prepared to describe your attacks in detail. When they started, what they feel like, what you were doing when they began, what (if anything) you have tried that helps. If you have had a recent cardiac or medical workup, bring those results.

After the evaluation, your clinician will share their assessment, discuss medication and behavioral options, and develop a plan with you. You will leave with clear next steps and a follow-up appointment, typically within two to four weeks.

Frequent questions

Questions about panic disorder.

Are panic attacks dangerous?

Panic attacks themselves are not physically dangerous. They are the body's threat-response system firing inappropriately. They feel medical because the same physiology is involved. That said, new chest pain or cardiovascular symptoms always deserve a medical workup; we coordinate with primary care or cardiology when the picture is unclear.

What medications are used for panic disorder?

First-line medications are SSRIs (sertraline, paroxetine, escitalopram) and SNRIs (venlafaxine). Benzodiazepines may be used short-term in specific clinical situations but are not typically a long-term solution due to tolerance and rebound risk. Your clinician will discuss the tradeoffs of any medication recommended.

Do I also need therapy?

Cognitive behavioral therapy with exposure (interoceptive and situational) is highly effective for panic disorder and pairs with medication for the most durable results. We can refer you to CBT-trained therapists in California if you do not already have one.

How quickly will I feel better?

Most patients begin to notice fewer or less intense attacks within 4-6 weeks of starting medication, with full effect at 6-12 weeks. Behavioral therapy works in parallel and can produce noticeable shifts within several weeks of consistent practice.

Can psychiatric care via secure video treat panic disorder?

Yes. Panic disorder evaluation and medication management is well-suited to telehealth. Feel August provides care via secure video throughout California.

Anxiety PTSD

See when you could meet your clinician.

Most patients book within two days.

See available times

Understanding panic disorder

Recognizing the signs

Sudden, unexpected episodes of intense fear or discomfort

Physical symptoms: racing heart, shortness of breath, sweating, trembling, chest pain

Sense of unreality or detachment during attacks

Persistent worry about having another attack

Avoidance of places or situations where attacks have occurred

Repeated emergency-department visits with negative cardiac workups

Symptoms persisting for more than a month

How we treat it

What the first conversation looks like

Questions about panic disorder.

Are panic attacks dangerous?

What medications are used for panic disorder?

Do I also need therapy?

How quickly will I feel better?

Can psychiatric care via secure video treat panic disorder?

Yes. Panic disorder evaluation and medication management is well-suited to telehealth. Feel August provides care via secure video throughout California.

When the alarm fires without a cause.

Understanding panic disorder

Recognizing the signs

How we treat it

What the first conversation looks like

Questions about panic disorder.

Often appears alongside.

See when you could meet your clinician.

When the alarm fires without a cause.

Understanding panic disorder

Recognizing the signs

How we treat it

What the first conversation looks like

Questions about panic disorder.

Often appears alongside.

See when you could meet your clinician.