Panic attacks are intensely frightening and overwhelming, especially when they seem to come out of nowhere. For some people, if they experience them at all, panic attacks are extremely rare and occur only during periods of high stress. For others, they become recurrent and lead to ongoing fears about when the next one might happen. This can in turn lead to avoidance of specific situations, places or people, out of the fear that the situation will trigger another panic attack. If this happens, the person might be struggling with Panic Disorder or Agoraphobia.
A panic attack is more than just strong anxiety. It is a sudden surge of intense fear that can be extremely overwhelming. For some people, panic attacks happen once or twice during particularly stressful periods, such as before a deadline, exam, presentation or major life event. Estimates vary, but research has found that between 13% and 22% of adults will experience at least one panic attack in their lifetime.
For others, panic attacks become more frequent and unpredictable. You might find yourself worrying about when the next one will happen, what it could mean, or how you will cope if it happens in public. Over time, these fears can start to shape your choices, routines and sense of freedom.
Panic attacks are not a sign of weakness, and they are not “all in your head”. They are real, intense body-based experiences that can become easier to understand and manage with the right support.
A panic attack is the body’s alarm system switching on very quickly and intensely. This alarm system is designed to help us respond to danger, but during a panic attack it can be triggered even when there is no immediate threat.
When this happens, the body releases stress hormones and prepares for action by triggering a series of physical changes, and the brain becomes highly alert to possible danger. These changes are part of the fight-or-flight response.
Panic attacks are different from a more gradual build-up of anxiety – the symptoms tend to come on suddenly and escalate quickly. They often peak within around 10 minutes, although they can feel much longer when you are in the middle of one.
When panic attacks are recurrent and followed by ongoing worry about having another attack, Panic Disorder can develop.
Agoraphobia can also develop when you begin avoiding specific situations because you fear panicking, feeling trapped, being embarrassed, or not being able to escape or access help in the event of another panic attack occurring.
Panic attacks can feel different from person to person, but common symptoms include:
Many people then develop a fear of the symptoms themselves (in essence, this is what Panic Disorder is). You might start scanning your body for signs of panic, avoiding exercise because it raises your heart rate, or develop safety behaviours such as sitting near exits, planning escape routes, or only going places with a trusted person.
When agoraphobia is present, you may avoid any situation that you worry you can’t readily cope with or escape from if panic symptoms were to occur. This might include lifts, planes, supermarkets, cinemas, public transport, busy shopping centres, bridges, tunnels, driving, being far from home, standing in queues, or staying in a room with the door closed.
While avoidance and safety behaviours can feel helpful in the short term, they often keep panic going by teaching the brain that these sensations and situations are dangerous.
Panic attacks happen when the body’s fight-or-flight system is activated. This system is designed to protect us from danger by preparing the body to respond quickly to threat. The suite of physical changes that are the fight-or-flight response are all useful if we need to fight or flee from a physical threat.
The problem is that this system can sometimes misfire. Stress, exhaustion, major life changes, health worries, trauma, anxiety, substance use, or long periods of emotional strain can make the threat system more sensitive. This can result in a panic attack occurring. Then once you have had a frightening panic attack, your brain may start watching closely for signs that it could happen again.
This creates a cycle: you notice a sensation, interpret it as dangerous, become more anxious, and then the sensations intensify. If you then avoid places where panic might happen, the fear can spread into more and more parts of life. This is one reason panic attacks and agoraphobia can become so limiting over time.
Understanding this cycle is often an important first step in reducing panic.
Therapy for panic attacks can help you make sense of what is happening in your body and reduce the fear attached to panic symptoms. Rather than simply trying to “calm down”, therapy focuses on changing the patterns that keep panic going.
Panic attack therapy may help you:
The goal is not to guarantee you will never feel anxious again. Instead, therapy helps you feel less afraid of anxiety, more confident in your body, and more able to live your life without panic or agoraphobia calling the shots.
Cognitive Behavioural Therapy, or CBT, is one of the most well-researched psychological treatments for panic attacks, panic disorder and agoraphobia. CBT helps you understand the connection between physical sensations, anxious thoughts, avoidance and panic.
In therapy, you may learn to identify catastrophic thoughts, such as “I’m going to faint”, “I can’t cope”, or “I’m having a heart attack”, and test these fears in a safe and structured way. You may also work gradually with feared body sensations, such as a fast heartbeat or breathlessness, so your brain can learn that these sensations are uncomfortable but not dangerous.
When panic is linked with avoidance or agoraphobia, therapy may also include gradual exposure to feared situations. This might involve slowly rebuilding confidence with places like shops, public transport, social events, cinemas, lifts, driving, crowded places, open spaces or being further from home.
Other approaches, including Acceptance and Commitment Therapy (ACT), mindfulness-based strategies, psychoeducation and self-help tools, can also support treatment. In some cases, medication may be discussed with a GP or psychiatrist alongside psychological therapy.
At Peaceful Mind Psychology, we understand how frightening and limiting panic attacks can feel. Many people come to therapy feeling exhausted by constant worry, embarrassed by avoidance, or unsure why their body seems to be reacting so strongly.
Our panic attack psychologists offer a warm, practical and evidence-based approach. We take time to understand how panic shows up for you, whether agoraphobia is also part of the picture, what situations you may be avoiding, and what you would like to feel able to do again.
We can support you with panic attacks, panic disorder, agoraphobia, health anxiety and related anxiety concerns. Therapy is tailored to your needs and may include CBT, psychoeducation, exposure-based strategies, mindfulness, ACT-informed skills and support for underlying stress or trauma if relevant.
We also know that starting therapy can feel daunting, especially if panic or agoraphobia has made new situations feel unsafe. Our psychologists and admin team will work with you at a pace that feels manageable, while gently helping you build confidence and reduce panic’s impact on your life.
If panic attacks or agoraphobia are affecting your relationships, work, study, sleep or ability to go about your day, you do not have to manage it alone. Support is available, and panic attacks are treatable.
If you’d like to learn more about overcoming panic attacks and agoraphobia, the Anxiety Recovery Centre Victoria runs support groups and has more information on their website.
A panic attack is a sudden episode of intense fear or discomfort, usually with strong physical symptoms such as a racing heart, dizziness or breathlessness. Panic disorder is when panic attacks become recurrent and are followed by ongoing worry about having more panic attacks, or a person changes in behaviour to try to prevent further panic attacks occurring. This can include avoiding certain places, activities or situations.
Panic disorder involves recurrent panic attacks and ongoing fear about having another panic attack. Agoraphobia involves fear or avoidance of situations where escape might feel difficult, help might not be available, or panic symptoms might feel hard to manage. The two often occur together, but not always. Some people have panic disorder without agoraphobia, while others experience agoraphobia without frequent panic attacks.
The length of treatment can vary depending on how long panic attacks have been happening, whether agoraphobia is present, and whether there are other concerns such as trauma, health anxiety or chronic stress. Some people notice improvement within a small number of sessions, while others benefit from longer-term support. Your psychologist can work with you to develop a treatment plan that matches your needs and goals.
During a panic attack, it can help to remind yourself that the symptoms are uncomfortable but not dangerous, and that they will pass. Slow, steady breathing, grounding techniques, and relaxing your body where possible may help reduce the intensity. We go more into these techniques in our post How to Stop A Panic Attack.
Longer term, therapy can help you understand the panic cycle, reduce fear of the symptoms, and respond differently when panic begins.