When the fear of the next panic attack starts organizing your life.
A panic attack is an intense, sudden surge of physical symptoms -- racing heart, chest tightness, difficulty breathing, dizziness, a sense of unreality or impending doom -- that peaks within minutes and can feel like a medical emergency. The attack itself is terrifying. What often follows is just as disruptive: the fear of having another one.
Willow & Arbor offers therapy for panic attacks and panic disorder in Johnson City, TN and by telehealth across Tennessee.
If this is urgent: if you're experiencing chest pain or symptoms you believe may be a medical emergency, call 911. If you're in mental health crisis, call or text 988. A therapy inquiry isn't the right starting point for immediate danger.
Panic attacks are physical events with psychological consequences.
The physical experience of a panic attack is real and intense. The difficulty breathing, the racing heart, the sense of unreality -- these aren't imagined. They're the body's threat response activating without a physical threat to respond to. That distinction matters for treatment.
The panic attack itself
Sudden onset of intense physical symptoms: racing heart, shortness of breath, chest tightness, dizziness, sweating, shaking, a sense of unreality, or fear of losing control. Peaks within minutes.
Anticipatory anxiety
Persistent worry between attacks about when the next one will happen. The anxiety about panic can become more disruptive than the attacks themselves.
Avoidance
Avoiding situations, places, or activities associated with previous attacks or where escape might be difficult. Avoidance narrows life and maintains the panic cycle.
Physical hypervigilance
Constantly monitoring physical sensations for signs of an incoming attack. This body scanning can itself trigger the physical symptoms it's watching for.
The fear of panic feeds the panic.
Panic disorder develops when the panic attack itself becomes the thing being feared. A racing heart is noticed, interpreted as dangerous, which creates anxiety, which increases heart rate, which confirms the feared interpretation. The body's normal physical sensations become triggers for panic because they've been linked to danger.
Avoidance provides short-term relief but maintains the cycle long-term. Every avoided situation teaches the nervous system that the avoidance was necessary, that the threat was real. The world gets smaller. Therapy interrupts the cycle at the level where it operates.
Breaking the connection between physical sensation and danger.
Therapy for panic at Willow & Arbor primarily draws on CBT, which is among the most well-researched approaches for panic disorder. The work involves understanding the panic cycle, changing the interpretation of physical sensations, and gradually reducing avoidance so that situations and sensations lose their threat association.
ACT may also be part of the work, focusing on building a different relationship to the physical experience of anxiety rather than eliminating it. The consultation helps clarify which approach may fit best.
Individual therapy is the primary starting point.
Individual therapy is the right starting point for most people experiencing panic attacks. Telehealth is available across Tennessee when clinically appropriate -- though for some presentations involving significant agoraphobia or avoidance, in-person therapy may be more effective for certain elements of the work.
When this fits, and when something else may be needed.
Willow & Arbor provides outpatient therapy. Rule out medical causes before beginning therapy for panic -- a medical evaluation can confirm that the physical symptoms aren't related to a cardiac or other medical condition. Therapy is most effective once medical causes have been addressed.
If panic is occurring alongside significant agoraphobia that prevents leaving home, a higher level of care or more intensive support may be needed initially. If panic is connected to generalized anxiety, trauma, or health anxiety, those pages offer more specific entry points.
Medical first: if you haven't had a medical evaluation for your physical symptoms, that's worth doing before beginning therapy -- not because the panic isn't real, but because ruling out medical causes clarifies the starting point.
Telehealth available: panic attack therapy across Tennessee when telehealth is clinically appropriate.
Safety comes first: if you're experiencing chest pain or symptoms that may be a medical emergency, call 911. For mental health crisis, call or text 988.
Fees and consultation
The initial consultation is free. Sessions are self-pay and vary by therapist and type of appointment. Willow & Arbor doesn't bill insurance directly. Therapy is provided by associate-licensed therapists under the clinical supervision of Dr. Katherine Barteck.
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In person in Johnson City, TN and by telehealth across Tennessee when clinically appropriate.
Learn about telehealthCommon questions about panic attack therapy
What's the difference between a panic attack and an anxiety attack?
A panic attack is a sudden surge of intense physical symptoms -- racing heart, difficulty breathing, dizziness, chest tightness, a sense of unreality -- that peaks within minutes and can feel like a medical emergency. An anxiety attack is a looser term often used to describe the buildup of anxiety over time. Panic attacks are distinct in their sudden onset and intensity. They can occur with or without an identifiable trigger.
Do I need to know what triggers my panic attacks for therapy to help?
No. Panic attacks sometimes have identifiable triggers and sometimes don't. Therapy for panic doesn't require you to have already figured out the cause. In fact, part of what therapy does is help identify the underlying patterns, whether those are specific triggers, general anxiety, avoidance behavior, or something else maintaining the cycle.
Can panic attacks be treated without medication?
Yes. CBT-based approaches are among the most effective treatments for panic disorder and don't require medication. Some people use medication alongside therapy, and that's a decision to make with a prescribing provider. Willow & Arbor provides therapy only, not medication management, but can work alongside a prescriber if medication is part of your treatment.
This page is provided for educational purposes only. The information here is not clinical advice about your particular situation, and reading it does not establish a therapeutic relationship with any Willow & Arbor therapist. Guidance that applies to your specific circumstances can only come from a direct professional relationship with a qualified provider.
Other concerns that may be connected
Panic attack therapy at Willow & Arbor is provided through individual therapy with telehealth available across Tennessee. See individual concerns, the full therapy-by-concern list, or all services.
The panic doesn't have to keep running the show.
The consultation can help sort out whether Willow & Arbor may be an appropriate fit and what kind of starting point makes sense.
If you're in crisis or immediate danger, call 911 or call or text 988. See our crisis resources.