Answers to Your Most Common Questions About Panic Attacks from a CBT Therapist
As a cognitive behavioral therapist (CBT), I work with clients every day who experience panic attacks—sudden, intense episodes of fear that can feel overwhelming and frightening. Many people come in with similar questions about these experiences, and addressing these questions is a significant part of building the understanding and skills needed to manage panic effectively. Here are some of the most frequently asked questions about panic attacks, with answers that I hope will provide clarity and reassurance.
Will My Panic Attack Last Forever?
This is a common question, and it’s understandable! When you’re in the middle of a panic attack, time seems to stretch, and it can feel as if the symptoms might never end. However, I can assure you that panic attacks are temporary. Most panic attacks peak within 10-20 minutes, and the intensity starts to decrease after that. It’s important to remember that while it feels frightening, your body is naturally built to calm down, and the symptoms will subside.
In CBT, we often work on reframing how you think about panic. When you remind yourself that “this will pass” and “panic can’t last forever” and focus on using calming techniques, it can help to reduce the length and severity of the experience.
I Have All These Scary Physical Sensations—Is Panic Harmful?
The physical sensations that accompany panic attacks, such as a racing heart, shortness of breath, sweating, or dizziness, can certainly feel alarming. However, panic attacks are not physically harmful. These sensations result from the body’s natural “fight-or-flight” response, a survival mechanism that prepares you to respond to perceived danger. During a panic attack, your body is responding as if there’s a real threat, even though there isn’t.
In therapy, I work with clients to better understand these sensations and to separate the physical feelings from the fear-based thoughts that often accompany them. This way, instead of interpreting a racing heart as something dangerous, you can learn to recognize it as a temporary physical reaction that will pass.
Does Panic Cause Heart Problems?
Many people are concerned that frequent panic attacks might lead to heart issues because of the strain they seem to put on the body. While a panic attack can feel like it’s taxing on the heart, especially if you experience rapid heartbeats or palpitations, there’s no evidence that panic attacks cause lasting heart damage.
In fact, panic attacks are a function of anxiety, not a physical heart condition. If you have an existing heart condition, it’s always wise to consult with a medical professional to rule out other causes of symptoms. However, if your heart is healthy, you can be reassured that while panic attacks feel intense, they are not damaging to your heart.
I Feel Dizzy During a Panic Attack—Will Panic Make Me Pass Out?
Feeling dizzy or lightheaded is a common symptom of panic attacks, and it can be very unsettling. However, fainting due to panic is extremely rare. The dizziness you experience is usually due to hyperventilation, which reduces the amount of carbon dioxide in your blood and creates that lightheaded feeling. It’s important to remember that dizziness doesn’t mean you’re in real danger, and it’s highly unlikely to lead to passing out.
One of the tools we use in CBT is learning to slow down your breathing, which can help balance the oxygen and carbon dioxide levels in your blood. Simple breathing exercises, like inhaling slowly for four counts, holding for four counts, and exhaling for four counts, can help alleviate dizziness and bring you back to a calmer state.
Will I Ever Stop Being Scared of My Panic Attacks?
The fear of panic attacks themselves can often be as challenging as the attacks, leading to what we call anticipatory anxiety. This is when someone becomes anxious about the possibility of having a panic attack, which can create a cycle of fear.
In CBT, one of our goals is to reduce this fear by helping you understand and reframe your thoughts about panic attacks. We use techniques like exposure therapy to gradually reduce the fear of panic symptoms. By facing certain physical sensations and situations in a safe and controlled way, many people find they become less afraid of panic over time. With practice, clients often report feeling less controlled by their fear and more confident in their ability to handle the sensations.
Why Do Panic Attacks Happen?
Understanding why panic attacks happen is essential for managing them. A combination of stress, past experiences, and certain thought patterns often triggers panic attacks. For some people, they seem to come out of nowhere, which makes them even more unsettling.
In CBT, we explore what might be triggering your panic attacks, whether it’s specific situations, places, or even certain thoughts. We’ll work to identify and understand the thought patterns that contribute to your panic and develop tools to address them, helping to reduce the frequency and intensity of your attacks.
Will CBT Help Me Stop Having Panic Attacks?
CBT is one of the most effective treatments for panic attacks. Through a structured approach, CBT addresses the thoughts and behaviors that contribute to panic. In our work together, we’ll explore:
Psychoeducation: Helping you understand what’s happening in your body and mind during a panic attack, which is often the first step toward reducing fear.
Cognitive restructuring: Challenging and changing unhelpful thoughts that fuel panic.
Exposure exercises: Gradually exposing you to the sensations or situations that trigger panic in a controlled, safe way, which can reduce sensitivity over time.
CBT doesn’t eliminate the fight-or-flight response but instead teaches you how to manage it effectively. Many clients find that, over time, they have fewer and less intense panic attacks.
What Should I Do When I Feel a Panic Attack Coming On?
When you feel a panic attack beginning, it can be helpful to have a few tools ready. Here are a few that I often recommend:
Grounding exercises: Focus on your surroundings to bring your attention back to the present moment. Describe objects around you, and notice colors, textures, or sounds to create a sense of grounding.
Talkback with the facts: Remind yourself of the facts you know about panic itself, like “panic can’t last forever” and “panic isn’t harmful.” These evidence-based statements can help reduce the intensity of the panic.
Practicing these strategies outside of panic attacks can make them easier to access and use in moments of high anxiety.
Can Avoiding Triggers Prevent Panic Attacks?
It may seem logical to avoid situations that trigger panic attacks, but avoidance often makes the problem worse over time. Avoidance reinforces the idea that these situations are dangerous, which can lead to increased anxiety and more panic attacks in the long term. In CBT, we work on gradually re-approaching feared situations in a way that builds confidence. Facing situations, rather than avoiding them, helps break the cycle of panic and allows you to regain control over your life.
Does Panic Have Any Long-Term Effects on My Health?
Panic attacks are distressing, but they don’t have lasting physical effects on your health. While chronic stress and anxiety may impact your well-being, isolated panic attacks themselves are not harmful. The real impact of panic attacks is often on your quality of life, as they can lead to fear of certain places or activities. With CBT, we address this by building coping skills and changing your response to anxiety, helping you reclaim your quality of life.
How Long Will It Take to See Results with CBT?
Every individual’s progress is different, but many clients start noticing changes within a few sessions. CBT is generally a short-term therapy, with many people achieving significant improvements in 12-20 sessions. We’ll work at your own pace, and I’ll provide tools and exercises that can help you feel empowered both during and after therapy. Remember, the skills you learn in CBT can continue to support you long after therapy is complete.
Is There Anything I Can Do on My Own to Help Between Sessions?
Absolutely! There are plenty of resources and strategies that can support you outside of therapy. Here are a few I often recommend:
Mindfulness practices: Apps like Headspace or Calm offer guided exercises to build mindfulness, which can help you become more comfortable with bodily sensations. Practicing mindfulness regularly encourages a greater awareness of the present moment, reducing the tendency to spiral into anxious thoughts during panic episodes.
CBT workbooks: Self-help books focused on panic, such as When Panic Attacks by David Burns, or Overcoming Anxiety and Panic: Interactive Guide by Elizabeth McMahon, offer additional exercises. These workbooks reinforce CBT techniques, allowing you to practice managing panic symptoms between sessions and build long-term resilience.
Regular physical activity: Engaging in consistent exercise helps reduce overall anxiety levels and can lower the frequency of panic attacks. Physical activity releases endorphins, which can boost mood and create a sense of calm over time.
Good sleep hygiene: Maintaining a regular sleep routine supports emotional resilience, reducing the likelihood of heightened anxiety. Quality sleep also helps regulate the nervous system, making it easier to manage stress and anxiety throughout the day.
Reduce alcohol and caffeine intake: Limiting alcohol and caffeine can help stabilize mood and decrease physical symptoms related to anxiety and panic. These substances can heighten heart rate and anxiety levels, so reducing them allows for a calmer, more balanced system.
These resources can be excellent tools to complement our work together, giving you more confidence in managing anxiety between sessions.
Final Thoughts
Panic attacks can feel overwhelming, but understanding their causes and learning how to respond effectively is empowering. In CBT, we focus on providing you with practical tools and strategies to manage panic and reduce its impact on your life. Remember, panic attacks are temporary and not harmful—by working through them with guidance and support, you can gain greater control over your experiences and ultimately live a life less dictated by anxiety.