You know firsthand just how frightening and jarring a panic attack can be. But then there’s a second layer of fear that doesn’t get discussed as much: the fear of when the next attack will happen.
That second fear can be worse than the attacks themselves. At least during a panic attack, you know what you’re dealing with. But the constant anticipation can start dictating your life, until eventually you’re avoiding people and places to prevent a panic attack from happening.
If any of this sounds familiar, this page is here to help. We cover:
A panic attack is a surge of intense fear that hits hard and fast, bringing many physical symptoms along with it. It can happen even when there’s no actual danger and, in many cases, no obvious cause at all. The National Institute of Mental Health (NIMH) describes it as a sudden wave of fear or a sense of losing control that occurs even when nothing threatening is happening.[1]
One of the things that makes panic attacks so frightening is how physical they feel. The body reacts as though it’s facing a real fight-or-flight situation, which is why a panic attack can be so distressing. You’re not imagining the fear. Your body is producing real physical symptoms even though there may not be a real physical cause.
The symptoms tend to arrive all at once, and they fall into two groups: physical and cognitive. Physical symptoms can include:
Cognitive symptoms can be the most distressing part and include:
Research lists these among the recognized symptoms of a panic attack, with a diagnosis including four or more of them appearing together.[2]
As overwhelming as they are, panic attacks usually peak within a few minutes and then start to fade. They’re not life-threatening, even though in the moment they can feel like they are.[1]
The physical side of panic attacks can be so convincing that those experiencing them genuinely believe their life is in danger. Symptoms such as chest pain and a racing heart can easily be mistaken for a heart attack. In fact, one study of emergency room patients arriving with chest pain found that a quarter of them were actually experiencing panic disorder.[3]
So why does a panic attack produce symptoms so powerful that they’re enough to make people seek medical help? The answer, in a lot of cases, is the panic cycle.
When a person experiences something slightly distressing, it sets off a number of reactions. For example, being startled might produce symptoms like a racing heart or perhaps even a tight chest. These signs come and go for a lot of people experiencing them, but in panic, the sensation gets read by the mind as though something is seriously wrong.
Research on the leading cognitive model of panic describes exactly this, where panic attacks come from misreading harmless bodily sensations as far more dangerous than they really are.[4] You feel your heart rate increase slightly. Your brain reads it as danger. Your body responds with a full stress response. That response produces more physical symptoms, which your brain reads as more danger. The cycle escalates.
This misreading sets off a chain reaction, causing the body to enter a state of fight-or-flight, which causes even stronger physical sensations. These symptoms seem to confirm to the brain that there is a threat, sending the response system into overdrive.[4]
Understanding the panic cycle is important because when a person experiences this process on a regular basis, it can fundamentally change how they live.
It’s worth noting that a single panic attack, or perhaps even 2 or 3, doesn’t equate to a person having panic disorder. The disorder itself is something more specific.
Panic disorder is described as a recurrent and unexpected panic attack, which is paired with worry about having more or changes in behavior aimed at avoiding them.[1]
The second part is what really defines panic disorder because the attacks are one thing, but the fear of the next one is what turns it into a disorder. This has a name, anticipatory anxiety, and it is sometimes described as the fear of fear. The person becomes so afraid of having another attack that the worry itself becomes a constant feature of day-to-day life. You’re not just scared during attacks, you’re scared:[5]
Avoidant behaviors then develop, where you avoid situations entirely in the hope of avoiding another attack.
The fear of having a panic attack, and even the attacks themselves, are enough to completely disrupt a person’s day-to-day life. While many areas of a person’s life are affected, below we explore three of the main ones.
The fear of having a panic attack in an important work meeting or at your desk in front of colleagues can make daily work life very difficult. Concentration becomes tough, and some people may start to miss work altogether.
Research on functional impairment in panic disorder found that people with the condition are less productive at work and face higher unemployment than those without it.[6]
When the fear of an attack is sitting in the back of your mind all day, it’s hard for your work not to suffer.
The Anxiety and Depression Association of America (ADAA) states that some people with panic disorder distance themselves from the very people who could support them through their symptoms, such as friends or family.[7]
Sometimes that could be down to feelings of embarrassment or the exhaustion of managing the condition. It can become easier to withdraw than to try to explain. The result is often growing isolation when connection would really help the most.
Avoidance has already been mentioned a lot on this page, but it’s a key factor in the development and maintenance of panic disorder symptoms.
The ADAA states that this interference is greatest when agoraphobia is present, as the avoidance disturbs more corners of a person’s life.[7]
For example, if the person experienced an attack in a supermarket, they might start to avoid that particular supermarket completely. Then it might progress to supermarkets in general and then to busy places altogether. The NIMH states that mental health conditions like agoraphobia can develop alongside panic disorder when these persistent avoidance behaviors occur.[1]
Eventually, a life is lived in smaller and smaller boundaries, organized entirely around preventing the next panic attack.
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
Experiencing panic disorder symptoms on a daily basis can be both exhausting and disheartening, especially if you’re questioning whether there’s a way out of this disorder. The encouraging news is that with a mix of the right pharmacological therapy and cognitive behavioral therapy (CBT), 80% of patients are able to recover from panic disorder.[8]
CBT is a first-line psychotherapy for patients with panic disorder. One of the most important aspects of it is something called interoceptive exposure, which targets the panic cycle.
Interoceptive exposure deliberately, but gradually, asks the patient to face the physical sensations associated with their version of panic.[1]
This exposure is done in a safe and controlled environment in order to show the person that while the sensations are uncomfortable, they’re not dangerous. Eventually, the body stops treating the panic disorder symptoms as a fight-or-flight response, which reduces the power of the panic cycle.
Studies show that exposure-based approaches, interoceptive exposure especially, were linked to the best results.[9]
Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used to treat panic disorder and are considered first-line medications for the condition.
Research shows that panic disorder is highly responsive to treatment, and it is clear that effective help is available regardless of how long someone has had the disorder or how severe it has become.[7] That last point really matters. Duration and severity don’t close the door on treatment.
For some, consistent, weekly outpatient therapy can be enough to keep panic disorder under control.
But for some people undergoing panic disorder symptom treatment, relapses can occur. Sources show that around 20% continue to have panic disorder symptoms that lead to a poor quality of life.[8]
For those people, an extra level of intensive care may be needed going forward, which is where residential treatment becomes a valid option.
The research favors intensive treatment for those with panic disorder. One study of an intensive treatment program found that around 90% of participants were able to return to their normal working life afterward.[10] This is a huge turnaround and a clear indicator of what concentrated, daily treatment can achieve when weekly sessions haven’t been enough.
There are two main advantages to residential treatment for panic disorder.
The first is intensity. Rather than one session a week in an outpatient setting, a residential setting gives you a chance to work on your recovery every day alongside a professional team. The difference between one hour a week and daily treatment is significant, especially for a condition maintained by avoidance patterns that need to be broken consistently.
The second is that residential treatment creates a temporary distance from your day-to-day life and the environments where panic has become embedded. Stepping away can be what finally breaks the panic cycle.
If panic has taken over daily life and standard treatment hasn’t been enough, a panic attack treatment center offering residential support for anxiety and panic disorder may be the next step worth considering.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Panic Attacks support is a phone call away – call 866-478-4383 to learn about our current treatment options.
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If you or someone you love is suffering from panic attacks and severe anxiety that are affecting daily life, AMFM (A Mission For Michael) Mental Health Treatment is here to support you. Our programs are built around the evidence-based approaches that are shown to work for panic disorder, including CBT and exposure-based therapy.
We offer an intimate, focused mental health treatment experience for adults in home-like settings that are carefully maintained to be peaceful, comfortable spaces. AMFM Mental Health Treatment provides the full spectrum of care, including residential and outpatient treatment programs.
Our team of expert clinicians believes in treatment persistence and will personalize your treatment plan so you can achieve lasting, life-changing outcomes.
Our locations in California, Minnesota, and Virginia accept insurance and are in-network with most major providers. To check your insurance coverage for mental health care, simply complete our confidential online verification form or call us at 866-478-4383.
Reach out to us if you would like to start the admissions process or learn more about how we can support your mental well-being. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation.
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Disabling panic disorder is when the condition becomes something that runs your entire life. The attacks are usually frequent, and the worry between them is constant. This worry then turns into the avoidance of people, places, situations, and even your ability to leave the house. More intensive treatment is usually needed in this situation.
Severe panic attacks happen when the panic cycle becomes too intense to deal with. The physical symptoms can mimic heart attacks and compound the fear. Severity can vary from person to person, but severe attacks are a sign that professional support is needed.
Panic disorder help is available through a mental health professional or a specialist treatment provider. In cases where outpatient treatment hasn’t worked, residential programs may be considered due to their higher level of care. Contact AMFM Mental Health Treatment to find out more about our panic disorder treatment.
Outpatient therapy and possibly medications are usually enough to bring panic disorder under control. But anxiety treatment in a residential setting becomes a valid option when panic disorder is severe and disabling.
At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
Our reviewers are credentialed medical providers specializing and practicing behavioral healthcare. We follow strict guidelines when fact-checking information and only use credible sources when citing statistics and medical information. Look for the medically reviewed badge on our articles for the most up-to-date and accurate information.
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