# Panic Disorder > A panic attack convinces the body it is dying and the mind that it is losing control. Then panic disorder builds a life around avoiding the next one. Both halves of that are treatable. **Source:** https://www.uniquembhs.com/anxiety-disorders-treatments/panic-disorder **Practice:** Unique Minds Behavioral Health Services, LLC. Baltimore, MD: 6810 Park Heights Ave, Suite C6, Baltimore, MD 21215 · Washington, DC: 1402 North Capitol St NW, #1, Washington, DC 20002 · Delaware, OH: 1 W Winter St, Suite 211, Delaware, OH 43015 **Phone:** (443) 538-8400 **Clinically reviewed by:** Dr. Ophilia Mbah, DNP, APRN, PMHNP-BC **Last reviewed:** 2026-08-11 ## Quick answer Panic disorder involves repeated, unexpected panic attacks (sudden surges of intense fear with pounding heart, shortness of breath and dizziness) followed by persistent worry about the next attack. Unique Minds treats panic disorder across Maryland, Washington, D.C. and Ohio with cognitive behavioral therapy, gradual exposure and medication management, in person or by secure video. ## What a panic attack actually is According to the [National Institute of Mental Health](https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms), a panic attack is a sudden surge of intense fear that peaks within minutes, with strong physical symptoms: racing heart, breathlessness, dizziness, trembling. It is the body's alarm system firing at full strength without a fire. The attack itself is not dangerous, but nobody who has had one needs telling how convincing it feels. Panic *disorder* is what develops around the attacks: weeks or months of worrying about the next one, and a shrinking list of places that feel safe to be if it comes. ## What happens in the body during an attack Understanding the mechanism is not a consolation prize, for panic specifically, it is part of the treatment, because every symptom in the list has a boring physiological explanation: - **Adrenaline releases**, and the heart speeds up to move blood to the muscles. That is the pounding chest. - **Breathing goes fast and shallow**, which drops carbon dioxide and produces the dizziness, the tingling hands and the feeling of not getting enough air. While you are in fact getting plenty. - **Blood shifts to the large muscles**, leaving hands and feet cold and numb. - **The digestive system pauses**, which is the nausea and the churn. - **Perception narrows and sharpens**, which can feel like unreality or detachment. None of it is dangerous, and all of it peaks and falls within minutes because the body cannot sustain that state. The danger a panic attack announces is the one thing about it that is not real. ## How panic disorder is diagnosed Two things have to be established, and the first one belongs partly to your medical doctor. **One: that the attacks are panic attacks.** Chest pain, breathlessness and palpitations deserve a medical workup, and we would never discourage one. Thyroid disease, heart rhythm problems, asthma, certain medications, stimulants and alcohol withdrawal can all produce something that feels identical. Panic becomes the working explanation when those investigations keep returning clear and the attacks keep returning anyway. **Two: that panic disorder, not just panic attacks, is present.** In a [psychiatric evaluation](/psychiatry-practices/psychiatric-evaluation) that means asking whether attacks come unexpectedly rather than only in one predictable feared situation, whether they have repeated, and whether the month since has been spent worrying about the next one or rearranging your life around it. That last part is the disorder, and it is the part most people never think to mention. ## What causes it There is no single cause. Panic disorder runs in families, which points at inherited biology, and first attacks frequently arrive during a period of stress, loss, illness or major life change, often, oddly, just after the crisis has passed rather than during it. What keeps it going is better understood than what starts it, and it is a loop: an attack teaches you to fear the sensations, fearing the sensations makes you monitor your body constantly, monitoring finds something (everyone's heart occasionally skips), and the alarm about that finding triggers the next attack. Avoidance then seals the loop by removing every chance to learn otherwise. Treatment works by breaking that circuit, which is why it works so reliably. ## How treatment works here After a [psychiatric evaluation](/psychiatry-practices/psychiatric-evaluation), which includes making sure nothing medical is masquerading as panic. [CBT](/therapy-services/cognitive-behavioral-therapy) does the heavy lifting. CBT for panic is specific: you learn what each symptom actually is (a racing heart is adrenaline, not a heart attack), then deliberately practise with the sensations in session until they lose their authority. Where avoidance has taken territory, [gradual exposure](/therapy-services/exposure-therapy) takes it back. [Medication](/psychiatry-practices/medication-management) is a useful second lever for many people, sometimes briefly, to make therapy possible; sometimes longer. It is always a decision made with you, reviewed as you improve. ## When to reach out If you have had more than one attack and the fear of the next one is steering your choices. What you drive past, what you decline, what you carry "just in case". Treatment can interrupt this far earlier than most people believe. The evaluation is a conversation in a chair, at your pace. ## What it can look like - Sudden waves of intense fear that peak within minutes, often out of nowhere. - A pounding or racing heart, chest tightness, or feeling unable to breathe. - Dizziness, trembling, sweating, chills or numb, tingling hands. - The certainty, in the moment, that this is a heart attack, or worse. - Fear of the next attack that never quite leaves the room. - Avoiding driving, crowds, lifts or leaving home in case one strikes there. - Emergency-room visits that end with "your heart is fine" and no plan. - A sense of unreality, as if you or the room has gone slightly unreal. - Attacks that wake you from sleep, with no trigger to blame. ## How we treat it - [Cognitive Behavioral Therapy](https://www.uniquembhs.com/therapy-services/cognitive-behavioral-therapy) - [Exposure Therapy](https://www.uniquembhs.com/therapy-services/exposure-therapy) - [Medication Management](https://www.uniquembhs.com/psychiatry-practices/medication-management) ## Frequently asked questions ### How do I know it was a panic attack and not a heart problem? You get that checked. Chest pain and breathlessness always deserve medical attention, and we would never talk you out of it. Panic disorder becomes the likely explanation when the cardiac workups keep coming back clear while the attacks keep coming back. At that point a psychiatric evaluation stops the cycle of scans and starts an actual plan. ### Can panic attacks be cured? Panic disorder responds very well to treatment. CBT for panic teaches your body that the sensations themselves are survivable, which switches off the fear-of-fear engine that keeps attacks coming, and medication helps many people alongside it. Most patients see attacks become rarer, weaker and far less frightening; for many they stop. ### I have started avoiding places in case I panic there. Is that part of it? Yes. That is how panic disorder grows, and in some people it develops into agoraphobia. Avoidance buys short-term safety and sells back a smaller life. Gradual, planned exposure is how the map gets redrawn, one reclaimed place at a time, at a pace you agree to. ### How is panic disorder diagnosed? Clinically, and after the medical questions have been answered. The diagnosis needs repeated unexpected panic attacks, not attacks that only ever happen in one predictable feared situation, followed by a month or more of persistent worry about the next one, or of changing your behaviour to avoid it. Your provider also reviews thyroid function, caffeine, stimulants, alcohol withdrawal and heart symptoms already investigated. ### Is a panic attack the same as panic disorder? No, and the difference matters. A single panic attack is common and can happen to almost anyone under enough stress; it is frightening but not in itself a disorder. Panic disorder is what develops when attacks repeat unexpectedly and the fear of the next one starts making your decisions, which places you go, what you avoid, what you carry just in case. That second part is what treatment dismantles. ## Sources - Panic Disorder: When Fear Overwhelms. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms ## Related pages - [Specific Phobias](https://www.uniquembhs.com/anxiety-disorders-treatments/specific-phobias-treatment) - [Generalized Anxiety](https://www.uniquembhs.com/anxiety-disorders-treatments/generalized-anxiety-disorder) - [Anxiety Disorders](https://www.uniquembhs.com/anxiety-disorders-treatments) --- This page is general health information, not medical advice. In a crisis, call or text 988 (988 Suicide & Crisis Lifeline) any hour, or call 911 in an emergency.