Best Treatment for Panic Attacks
Backed by science
Five Best Science-Backed Treatments
There are 5 distinct treatment styles that researchers have shown to be effective for panic attacks. These 5 different styles can be broken down into two broad categories: Behavioral and pharmacological. The first thing that most people reach for when they first develop panic attacks is medication, which is a pharmacological approach. Unfortunately, trying to cure panic attacks only with medication is most likely not going to work. Medication and psychological treatment both relieve panic equally well, but medication has a really bad relapse rate.
Below you’ll learn more about medication, the 3 most validated behavioral interventions, and the emerging research pointing to what might be the most effective treatment for panic attacks to date.
Medication
Medication is the simplest of all options and depending on your insurance, it can also be the cheapest of all options. The downside of this option is that medication is not a permanent solution.
When the medication is stopped, panic most likely will return. The word for that is relapse rate and the common medications used to treat panic attacks have relapse rates as high as 80%. By comparison, behavioral interventions have a relapse rate of only 15%.
The most commonly used drugs are benzodiazepines and antidepressants. Benzodiazepines are effective and fast acting drugs with a high addiction potential. Antidepressants, on the other hand, can take a few weeks to start working. However, they have a low risk for abuse and don't make people as groggy as benzodiazepines. Despite the fact the medication does not solve the problem permanently, the benefit of medication cannot be overstate. It is an excellent tool to rely on temporarily, when someone has become too depressed to heal themselves naturally. If you like the idea of medication, then you have to find a psychiatrist.
If there is a shortage of psychiatrists in your area, then your primary care physician may step in to fill the void.
Cognitive Behavioral Therapy
Cognitive behavioral therapy helps us understand very clearly how our thinking causes panic attacks. We then come up with alternative thought processes that replace the faulty ones. It is a very cerebral form of therapy. A lot of research on panic was actually done using CBT only. Up to 85% of patients responding positively to it within 10-15 sessions.
The way this helps is by helping us understand very clearly how our style of thinking causes panic attacks. We then come up with alternative thought processes that replace the faulty ones. It is a very cerebral form of therapy. A lot of research on panic was actually done using CBT only, and we know that CBT alone can help some people, but not everyone. This is because CBT addresses only half of the problem.
Panic disorder is made up of two problems. One is cognitive, and CBT is great at addressing that. The other one is bodily, and that's where CBT falls short. However, Exposure Therapy shines at that.
Exposure Therapy
Exposure therapy is essential to the treatment of panic attacks. It refers to putting a person in front of the thing that they fear until they stop fearing it. A subcategory of Exposure Therapy is something called Interoceptive Exposure Therapy. The word “Interoceptive” means that we are focusing on feelings we perceive to be originating from within or on our bodies.
Our panic is fueled by our fear of the experience of a panic attack. Our experiences are composed of our thoughts and how we physically feel. Therefore, half of what we fear about panic attacks is how it physically makes us feel. In order to stop the cycle of panic, we have to stop fearing those experiences, and interoceptive exposure therapy is one way of accomplishing that.
(I know it’s confusing. Book a free consultation and I’ll explain it all in detail).
Acceptance & Commitment Therapy
Research suggests that ACT shows promise in the treatment of panic disorder, and that’s no coincidence. The “Acceptance” component of ACT refers to the practice of accepting our circumstances. The more we accept our circumstances, the more we stop fighting our present experience. The more we accept our present experience, the less we’ll resist the experience of a panic attack.
When we give in to the thing that we fear the most, when we stop fighting it, we may realize that all the misery and the pain actually came from the act of fighting it; from resisting our experience.
Panic attacks make us act frantic on the inside. We frantically try to stop what is happening. The level of frantic behavior is a lot like what a child does when he’s fighting someone off: He braces for impact by closing his eyes, while flailing his arms wildly at the threat. Accepting our present circumstances is the equivalent of the child stopping long enough to open his eyes and notice that there was nothing in front of him this entire time.
The benefit of this technique is that if you pull it off just once, not only will you interrupt a panic attack as it is happening, but you’ll also gain the confidence that you can now handle panic attacks in the future. Often just having one moment of acceptance is enough to reduce the frequency and intensity of panic by a very significant amount. That was my experience, and that was the experience of some of the clients that I've worked with in the past.
The downside of this technique is that it’s one of the most difficult ones to pull off by itself. But that's okay because we have multiple approaches and the best approach is yet to come. The best approach is a combination of techniques.
The Best Treatment
All interventions, in the right order
Emerging research suggests that treatment effectiveness can be dramatically increased by combining all of the interventions mentioned on this page, in the right order. It's like that saying: “The whole is greater than the sum of its parts.”
The simplest way to understand the process is to think of treatment for your panic as one giant session of Systematic Desensitization (a form of exposure therapy; see above).
In systematic desensitization, we break the process down into more and more difficult challenges where the first challenge is easiest, and the last is hardest. The concept here works exactly the same as with strength training: You start with light weights, get stronger, and eventually lift heavy.
Each intervention that we described on this page has different difficulty levels. Some are easier and some harder. By starting with the easier ones, we can weaken your panic to such a degree that the more difficult interventions become easier and even more effective.
The 3 T’s of Good Therapy
Tact
Because serious panic problems are rare (2.5% - 5% of the population), not many people can understand the full spectrum of the experience. I personally understand it because I lived it, and so I have an easier time explaining the solutions in such a way that it makes sense.
Timing
Knowing when to apply a new technique, or when to turn up the difficulty requires either personal experience with panic, or a lot of experience of working exclusively with panic attacks. In my case, I have both.
Titration
It’s not enough to know when to apply a new technique, or when to switch to a more challenging exposure. It’s also important to know whether the client is sufficiently prepared to deal with the next challenge. Once again, this comes naturally to me because of my history.
Learn More
Free online panic attack workshops
Read about our free online panic attack workshops where you’ll learn how to overcome your panic attacks in a supportive community.
Learn how to stop a panic attack
Learn tips and tricks that you can try next time you’re having a panic attack. They’re simple, and easy to do.
What is a panic attack?
Learn if you actually had a panic attack by learning the technical definition of a panic attack, as defined by The Diagnostic and Statistical Manual (5th Edition).
5 best treatments for panic attack
Learn about the 5 best, scientifically supported treatments for panic. No matter what the nature of your panic, at least one of these will be involved.
Learn about what causes panic attacks
Panic attacks play a role in 7 different mental health disorders. Learn about them here.
1-on-1 therapy for panic attacks
Learn about how our psychotherapists can help you start feeling better.
Meet the Owner
Adam J. Biec, LMHC / LPC
“My name is Adam J. Biec. I am Licensed Mental Health Counselor and a Licensed Professional Counselor, and I used to have a panic disorder. I learned how to eliminate them and became passionate about helping others get rid of their panic attacks as well.
My clients often say that talking to me about their panic attacks is like a breath of fresh air, because it’s so hard for most people to understand their experience. I understand the experience because I lived it. Having that personal experience with panic also made it easier for me to help others, because I know how to navigate the problem.
Right now, the most important thing I need you to know is that it is absolutely possible to get rid of your panic attacks. I did it, I’ve seen my clients do it, scientific research suggests it, and I know that it’s possible for you to do it as well.”
What People Are Saying
“Adam has been very helpful to me. I went to him for help with panic attacks, but he helped me overcome them. What he said made sense from the start. It was hard for me to describe what I was going through w other people, but he knew what I was going through and could relate, which made me feel comfortable. Most of my panic attacks have stopped. I have a lot more to go, but I know what I have to do now! I definitely recommend him!”
— ZocDoc Reviewer
“After suffering from anxiety and panic attacks for most of my life, and as it got increasingly worse this past year, I sought out a therapist and was lucky to find Adam through Zocdoc. I tried a therapist once in the past, but I had a horrible experience so I was definitely hesitant about going in. But after coming highly-recommended, I met with Adam who provided a very safe environment to talk. He has significantly helped me cope with my anxiety and provided extremely useful techniques when it comes to approaching and overcoming it. He is very personable and just a pleasure to talk to about anything. I wish I could give him more than 5-Stars. I can't thank him enough for everything he has done for me!”
— ZocDoc Reviewer
“Adam is above all a wonderful person, who truly cares about improving the life of his patients. I am so glad I found Adam: he is a rare gem, an incredibly smart and approachable person. If you are lucky enough to work with him, I am certain you'll see rapid improvements, whatever your goals may be. I highly recommend Adam's practice.”
— Google Reviewer
How I Can Help You
Free Consultation
Book a free 15 minute consultation with me below. I’d be more than happy to share with you my professional opinion.
1-on-1 Therapy
1-on-1 therapy is the most commonly utilized modality when treating panic attacks. The main benefit of this modality is that you regularly receive individualized attention from the therapist. This allows the therapist to quickly correct any misunderstandings and troubleshoot sticking points. The downside is the cost.
Feel free to book a free 15 minute consultation with me below. Even if you don’t intend to book any sessions with me, I’m more than happy to share my professional opinion on your situation.
Free Online Panic Workshops
I created these free panic online workshops because I noticed that a lot of people needed help, but the cost of 1-on-1 therapy was prohibitive. The instruction that I give during these workshops is identical to what I would give in a 1-on-1 session. The difference is that I am not contracting with you for individual therapy. Instead, it’s an educational workshop where we learn from each other’s examples.
The upsides are the monetary savings and having access to a community that understands what you’re going through. The downside of this approach is that I can’t give everyone individualized attention. However, there is a solution for that. I offer Troubleshooting Sessions in case whatever situation you’re dealing with requires more individualized attention.
The other benefit of these workshops is that it gives you a chance to test-drive me as your therapist in case you are considering a more individualized, 1-on-1 approach to your treatment.