Panic Disorder Therapy Online

What Is Panic Disorder?

A panic attack is a sudden surge of intense fear that peaks within minutes. It brings physical symptoms such as a racing heart, shortness of breath, dizziness, sweating, trembling, or a feeling of unreality. Many people have a panic attack at some point. Panic disorder is diagnosed when attacks come unexpectedly and repeatedly, and you spend at least a month worrying about more attacks or changing your life to avoid them.

Some people also develop agoraphobia, which means avoiding places where escape or help might feel hard to reach, such as stores, highways, crowds, or being far from home.

Why Panic Attacks Keep Coming Back

Panic disorder is driven by a cycle:

1. You notice a normal body sensation, such as a faster heartbeat.
2. You interpret it as dangerous (“I’m having a heart attack,” “I’m going to faint”).
3. Fear triggers more physical symptoms, which seem to confirm the danger.
4. You start avoiding situations and sensations, and you rely on “safety behaviors” like carrying water, sitting near exits, or never going out alone.

Avoidance and safety behaviors feel protective, but they keep your brain from learning that the sensations are uncomfortable rather than dangerous.

CBT for Panic Disorder, Step by Step

CBT for panic is a structured, short-term treatment. It’s recommended as a first-line treatment by clinical guidelines, including those of the American Psychiatric Association and the United Kingdom’s National Institute for Health and Care Excellence (NICE). It usually takes about 10 to 15 sessions and includes:

• Education. You learn what panic is, and why it isn’t dangerous.
• Cognitive restructuring. You examine catastrophic interpretations and replace them with accurate ones.
• Interoceptive exposure. You deliberately bring on panic-like sensations in a controlled way until they stop being scary.
• Situational exposure. You gradually return to places and activities you’ve been avoiding.
• Dropping safety behaviors, so you learn you can cope without them.
• Relapse prevention, so you know what to do if panic ever returns.

What Is Interoceptive Exposure?

Interoceptive exposure is a core part of CBT for panic. With your clinician’s guidance, you practice exercises that safely produce the sensations you fear, among others:

• Spinning in a chair to feel dizzy
• Breathing through a thin straw to feel short of breath
• Running in place to raise your heart rate

By repeating them, your brain learns that these sensations are harmless and that you can ride them out. The fear of the sensations, which is the engine of panic disorder, fades.

Panic and Agoraphobia

When panic leads to avoiding places or travel, treatment adds gradual, planned practice in those situations. Online therapy can actually help here: your clinician can support you by video while you practice at home, in your car, or out in your neighborhood.

Online Therapy for Panic

Research shows CBT delivered by video can be as effective as in-person CBT for anxiety disorders, including panic. Being able to start treatment from home is especially helpful if panic has made leaving the house hard. Learn how our teletherapy works.

You may also find these articles helpful: what causes anxiety and panic attacks, what causes panic attacks at night, and how to calm yourself during an anxiety attack. For other anxiety concerns, see our anxiety therapy page.

Common Panic Symptoms

During a panic attack, people often notice several of these:

• Pounding or racing heart
• Shortness of breath or a feeling of choking
• Chest tightness or discomfort
• Dizziness, lightheadedness, or feeling faint
• Sweating, chills, or hot flashes
• Trembling or shaking
• Nausea or stomach distress
• Numbness or tingling
• Feeling detached from yourself or your surroundings
• Fear of losing control, “going crazy,” or dying

These sensations come from the body’s normal fight-or-flight response, turned up very high at the wrong time.

Panic Attacks vs. Panic Disorder vs. Heart Problems

	Panic attack	Panic disorder
What it is	A sudden wave of intense fear and physical symptoms	Repeated, unexpected attacks plus ongoing worry about them
How common	Many people have one at some point	A smaller group who need treatment
Treatment	Often none needed	CBT for panic is first-line

Panic symptoms can resemble heart or breathing problems. If you’ve never had a medical evaluation for your symptoms, or your symptoms change, see your doctor first. Once medical causes are ruled out, repeated emergency visits for the same symptoms are often a sign that panic is driving the cycle.

A Typical Course of Treatment

• Weeks 1–2: Learning about panic, tracking attacks, and mapping your personal cycle
• Weeks 3–5: Cognitive work on catastrophic thoughts, and starting interoceptive exposure
• Weeks 6–10: Gradually returning to avoided places and dropping safety behaviors
• Final sessions: Building a relapse-prevention plan

Many people notice their attacks becoming less frequent and less frightening within the first month, even before they stop completely.

How Loved Ones Can Help

Family members can help most by staying calm during an attack, avoiding rescuing you from feared situations, and encouraging your practice instead of reinforcing avoidance.

Insurance Coverage

We’re in-network with Aetna, Optum and UnitedHealthcare, Oscar (through the UnitedHealthcare network), Anthem and Carelon (through Headway), Blue Cross Blue Shield, Ambetter, and others.

We do not accept Medicare or Medicare Advantage plans.

Our clinicians are licensed across 20 states, and we have in-person offices throughout the US.

Frequently Asked Questions

Can panic disorder be treated without medication? Yes. CBT alone is a first-line treatment, and many people become panic-free without medication. Some people choose to combine therapy with medication prescribed by their doctor.

How long does CBT for panic disorder take? Most people complete treatment in about 10 to 15 weekly sessions, and many notice improvement within the first few weeks.

What is the fastest way to stop panic attacks? In the moment, slowing your breathing and letting the wave pass without fighting it can help. For lasting change, CBT with interoceptive exposure is the most effective approach.

Can a panic attack hurt me? Panic attacks feel dangerous, but they aren’t harmful in themselves. If you have new or unexplained chest pain or other symptoms, see a doctor first to rule out medical causes.

Is online therapy effective for panic attacks? Yes. Research shows video-based CBT can work as well as in-person treatment for panic and other anxiety disorders.

Is panic disorder treatment covered by insurance? Usually, yes. It’s typically covered as outpatient psychotherapy. We’ll check your benefits before you start. We do not accept Medicare or Medicare Advantage plans.

If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.