Fear of another panic attack is common, and it’s treatable. Attacks peak fast, fade on their own, and aren’t dangerous, but dreading the next one makes people avoid places, which keeps the fear alive. Therapy, medication, or both can break that loop, and so can slowly returning to the places you’ve been dodging.
You’re in the middle of a crowded store when your heart starts pounding. Your hands tingle. You’re sure something is badly wrong.
Ten minutes later, it’s over. You’re fine, just shaky and embarrassed.
But now you don’t go back to that store. Or you go, but you stand near the exit and keep checking how you feel. That’s the part nobody warns you about. The attack ends, but the dread doesn’t.
What Does a Panic Attack Actually Feel Like?
It’s different for everyone, but most people describe some mix of these:
- A heart that’s racing or pounding
- Sweating, or sudden chills
- Shaking
- Not being able to catch your breath
- Dizziness
- Chest pain
- Nausea
- A feeling that you’re losing control
Most attacks last a few minutes. A few drag on for an hour or more. The National Institute of Mental Health (NIMH) says panic attacks themselves aren’t life-threatening. That’s true, and it’s also nearly impossible to believe while one is happening.
Why Do You Keep Dreading the Next One?
Your brain is trying to protect you. It’s just doing a clumsy job.
After a scary attack, it starts watching for any sign of another. Your heart speeds up because you climbed a flight of stairs, and suddenly you think, here it comes. That jumpy, braced feeling has a name: fear of fear. It’s a big reason panic sticks around.
Then there’s avoidance. You skip the place where it happened. It feels like the smart move.
It works against you, though. Each time you avoid something, you lose the chance to find out you could have handled it. The fear never gets challenged, so it just keeps growing.
What’s the Difference Between a Panic Attack and Panic Disorder?
Plenty of people have one attack and never have another. That alone isn’t a disorder.
| Term | What It Means |
| Panic attack | A sudden burst of intense fear with physical symptoms. Many people have one or two in their lives and never need treatment |
| Panic disorder | Repeated, unexpected attacks, plus at least a month of worrying about more, fearing what they mean, or changing your habits to avoid them |
| Agoraphobia | Fear of places or situations where escape might be hard or help might not come. It can develop alongside panic disorder |
Panic disorder often starts in the late teens or early adulthood. It’s more common in women than in men.
How Does Avoiding Things Take Over?
Slowly, and quietly. Nobody decides to shrink their life. It just happens a little at a time.
First you stop taking the freeway. Then you only shop early in the morning when the store is empty. You start leaving parties after twenty minutes. You won’t go anywhere unless a friend comes along. Some people carry water, a phone, and medication everywhere, even though they’ve never needed any of it.
Each habit makes sense on its own. Add them up, though, and you’ve got a very small life.
What Should You Do When One Starts?
You can’t shut a panic attack off like a faucet. But you can stop feeding it.
A few things that help many people. None of them replace treatment:
- Remind yourself it ends. The peak is short.
- Breathe in through your nose, then let a longer breath out.
- Name five things you can see, four you can touch, three you can hear.
- Try not to wrestle with the feelings. Fighting them usually makes them louder.
- If you can, stay. If you need a minute outside, take it, then go back in.
Could It Be Your Heart?
It’s a reasonable thing to wonder. Chest pain shows up in panic attacks and in heart problems, and MedlinePlus says you shouldn’t assume it’s panic alone.
So get new or severe chest pain checked. Your provider may rule out other causes first.
Call 911 right away for severe or new chest pain, pain that spreads to your arm, jaw, or back, trouble breathing that doesn’t ease, or fainting.
What Treatments Actually Work?
Good news here. Treatment is effective for panic disorder. Most people require therapy, medication or a combination of both and sometimes it takes a couple of tries to find the right fit.
Therapy. There is the most research to support cognitive behavioral therapy. It helps you to identify those negative thoughts and then respond to those thoughts in a different way. Some therapy incorporates interoceptive exposure, which means you are asked to provoke panic-related thoughts or feelings, such as a racing heart, in a safe environment, so you can learn that it won’t harm you.
Medication. Commonly used first-line medications are the SSRIs and SNRIs, which may take several weeks to take effect. Beta-blockers can help to reduce physical symptoms such as rapid heart rate. Benzodiazepines are fast acting drugs but often used only for a short duration as there is a risk of tolerance and dependence.
Everyday habits. Helpful tips include getting more sleep, exercising, eating regular meals and cutting back on caffeine and alcohol. Before using a calming supplement, ask your provider.
Everyday habits. Sleep, exercise, regular meals and less caffeine and alcohol all help. Ask your provider before trying a calming supplement. Mayo Clinic warns that kava has been linked to serious liver damage.
How Do You Start Going Out Again?
- Write down the places and situations you avoid, from easiest to hardest
- Pick something small, like a short walk or a quick stop at a quiet store
- Stay until the anxiety eases, even if that takes a while
- Do it again until it gets easier
- Move up one step
You’ll have off days. That’s normal, and it doesn’t erase your progress. NIMH suggests being patient with yourself.
What if It Happens Again?
It might. That doesn’t mean treatment failed.
When it does, tell yourself it’s uncomfortable and not dangerous – that you’ve gotten through it before and that it will peak and fade. Afterward, jot down what happened and tell your provider so they can adjust your plan.
When Is It Time to Get Help?
If attacks keep happening, if you’re skipping things you used to do or if the fear is hurting your work, school, or relationships – it’s time. Same if you’ve started drinking to take the edge off, or you just feel worn out and hopeless.
If you’re in crisis or having thoughts of suicide, call or text 988 any time. In a life-threatening emergency, call 911.
How Can Medcanvas Psychiatry Help?
At Medcanvas Psychiatry in Minot, North Dakota, we treat panic disorder, anxiety, social anxiety, depression, and PTSD. We start with acomprehensive psychiatry assessment to understand what’s going on, then offer medication management and therapy built around you. Our provider is trained in cognitive behavioral therapy, interpersonal therapy, and motivational interviewing.
If getting out the door is the hard part, telepsychiatry lets you start from home.
- Address: 104 20th Ave. SW, Suite 4, Minot, ND 58701
- Phone: 701-963-6917
- Email: contact-us@medcanvaspsychiatry.com
- Insurance: We work with many plans. Please contact us to confirm yours.
Ready to talk? Book an appointment or call 701-963-6917. You can also read more on our blog.
FAQ
Can a panic attack hurt you?
No. NIMH says panic attacks themselves aren’t life-threatening. They feel terrifying, so it’s still smart to have new chest pain checked.
Why am I so afraid of having another one?
It’s called fear of fear. After a scary attack, your brain watches for signs and steers you away from triggers. That worry can keep the cycle going.
Does avoiding places help?
Only for a moment. Over time it usually makes the fear stronger. Going back gradually, with support, is a key part of treatment.
Do I need medication?
Not always! Therapy, medication, or both can work, depending on your symptoms, history, and preferences.
How long does treatment take?
It varies! SSRIs can take several weeks to work and therapy progress depends on the person. Your provider can give you a realistic timeline.
The Bottom Line
The attack passes. The fear of the next one is the part that takes work, and it can be unlearned.
You don’t need to have it figured out first. Making the call is enough.
Take the next step: Contact Medcanvas Psychiatry today.
This article is for education only. It isn’t medical advice, diagnosis, or treatment.
Sources
- National Institute of Mental Health. Panic Disorder: What You Need to Know
- Anxiety and Depression Association of America. Panic Disorder: Minimizing Fear, Tolerating Symptoms, and Building Skills
- Mayo Clinic. Agoraphobia: Diagnosis and Treatment
- MedlinePlus. Panic Disorder
