If you've struggled with panic attacks for years, you've probably tried everything to make them stop.
Deep breathing, grounding techniques, positive self-talk, avoiding triggers, or reminding yourself that you're safe.
Maybe some of these strategies helped temporarily, but you're still constantly worried about having another panic attack.
That's because panic disorder isn't just about experiencing panic attacks. It's also about developing a fear of having another one.
So what does treatment actually look like when the goal is to stop fearing panic rather than constantly trying to prevent it?
What Is the Best Treatment for Panic Disorder?
Cognitive behavioral therapy (CBT) that includes exposure therapy is a first-line, evidence-based treatment for panic disorder. Exposure and Response Prevention (ERP) principles can be used to help people approach feared sensations and situations while reducing avoidance and safety behaviors.
Rather than teaching you more ways to control panic, exposure-based treatment helps you change how you respond when panic shows up.
The goal isn't to guarantee you'll never experience anxiety again.
It's to help you stop organizing your life around the possibility of panicking.
What Happens During Your First Panic Disorder Therapy Session?
Your first session typically focuses on understanding your experiences with panic.
Your therapist may ask about:
When your panic attacks started and what they feel like.
Which physical sensations frighten you most.
Situations you've started avoiding because of panic.
What you do to prevent, escape, or control panic attacks.
How panic has affected your relationships, work, travel, or daily activities.
Together, you'll identify the patterns keeping you stuck in the panic cycle and develop an individualized treatment plan.
How Does Exposure Therapy for Panic Attacks Work?
Exposure therapy for panic involves gradually and intentionally approaching feared sensations and situations instead of avoiding them.
There are two common types of exposure used in panic disorder treatment.
Interoceptive Exposure
Interoceptive exposure involves intentionally experiencing physical sensations associated with panic.
Depending on your health history and treatment plan, exercises might involve safely increasing your heart rate, creating mild dizziness, or noticing changes in your breathing.
The purpose isn't to eliminate these sensations.
It's to practice experiencing them without immediately trying to escape or control them.
Situational Exposure
Situational exposure involves returning to places or activities you've been avoiding because you're afraid of panicking.
For example, you might practice:
Driving farther from home.
Standing in a grocery store checkout line.
Attending meetings without sitting near an exit.
Going to restaurants without planning an escape route.
Traveling without relying on unnecessary safety behaviors.
Exposures are collaborative, individualized, and adjusted to your circumstances.
What Does Response Prevention Look Like for Panic Disorder?
Exposure is only part of the process.
Response prevention means practicing not doing the things you typically rely on to prevent, escape, or neutralize panic.
For example, you might work toward reducing:
Constantly checking your heart rate or breathing.
Mentally reassuring yourself that you won't panic.
Scanning your body for signs of another attack.
Leaving situations immediately when anxiety increases.
Repeatedly researching symptoms to feel certain you're okay.
The goal is to learn that you can experience discomfort and uncertainty without automatically responding with avoidance or safety behaviors.
Will Exposure Therapy Make My Panic Attacks Worse?
Exposure therapy can temporarily increase anxiety because you're intentionally approaching experiences you've been avoiding.
However, treatment should be carefully planned, collaborative, and appropriate for your medical circumstances.
You're not expected to jump into your most feared situation immediately.
Instead, you and your therapist work together to build your ability to approach panic without relying on the same avoidance patterns.
Can ERP Help With Panic Disorder and Agoraphobia?
Yes. Exposure-based treatment is also commonly used when panic disorder occurs alongside agoraphobia.
If you've stopped driving on highways, traveling, shopping alone, or going far from home, treatment can help you gradually return to those activities.
Recovery isn't about waiting until you feel completely calm before living your life. It's about learning to participate in life even when anxiety is present.
Panic Disorder Treatment in Reston, VA
At Regnier Restorative Counseling, I specialize in helping adults who have spent years trying to stop panic attacks but still live in fear of another one.
I provide specialized exposure-based therapy for panic disorder and agoraphobia, helping clients reduce avoidance, change their responses to panic sensations, and return to activities that matter to them.
I offer in-person panic disorder treatment in Reston, Virginia, and virtual therapy throughout Virginia, Washington DC, Maryland, Indiana, and Michigan.
Learn more about my approach to ERP for panic attacks or visit my website to schedule a free 15-minute consultation.
You don't have to keep waiting until panic disappears to start getting your life back.
