A panic attack feels like danger. It isn't dangerous.

A panic attack is a false alarm. Your body fires off its full threat response, racing heart, shortness of breath, dizziness, a wave of fear that you might be dying or losing control, when there's no actual danger in front of you. It feels like an emergency, and it's genuinely terrifying. But the panic itself, as awful as it is in the moment, isn't harming your heart or your brain.

For some people it happens once or twice and fades. For others it becomes panic disorder, where the attacks recur and you start reorganizing your life around avoiding them. That can grow into specific phobias, social anxiety, or agoraphobia, the fear of being somewhere you can't easily leave or get help. The fear of the next attack often becomes as limiting as the attacks themselves.

Panic responds well to treatment. Most people get meaningful relief once they understand what's happening in their body and have a plan that fits them. Part of good care is also ruling out the medical conditions that can imitate panic, like thyroid problems, heart rhythm issues, or certain medications, so we're treating the right thing.

Signs we look for

• Sudden waves of intense fear that peak within minutes, often out of nowhere
• Physical surges during an attack: pounding or racing heart, chest tightness, shortness of breath, sweating, shaking, or dizziness
• A feeling that you might be dying, having a heart attack, losing control, or going crazy
• Persistent worry about when the next attack will come, sometimes for weeks afterward
• Avoiding places, situations, or activities that you associate with panic
• Strong, specific fears (driving, flying, crowds, being far from home) that shrink what your life looks like
• Repeated trips to the ER or urgent care that come back clear

How we evaluate it

We start with a careful history of what your attacks actually feel like, when they happen, and how they're shaping your choices. Panic can look like, and sometimes coexist with, several medical conditions, so we screen for the things that imitate it: thyroid imbalance, cardiac and rhythm issues, caffeine and stimulant use, and certain medications. Where something medical needs ruling out, we say so and coordinate with your primary care doctor rather than guessing. We also sort out whether what you're experiencing is panic disorder, a specific phobia, social anxiety, agoraphobia, or panic riding alongside another condition like depression or trauma, because the right plan depends on getting that picture clear.

How we treat it

The strongest long-term results for panic and phobias usually come from cognitive behavioral therapy and exposure work, which retrain your body's alarm so feared situations stop running your life. Sigma provides the psychiatric side of that care: a thorough evaluation, education about what panic is doing in your body, and medication when it's helpful. We also help you connect with a CBT or exposure therapist and coordinate alongside them. When medication fits, SSRIs and SNRIs are the usual first-line choices and aren't controlled substances, which makes them well suited to steady, ongoing use. Benzodiazepines can calm an acute attack, but they're habit-forming, lose effect over time, and can get in the way of the exposure work that actually resolves panic, so we use them sparingly if at all, for the short term, and we explain the tradeoffs and the state and telehealth rules that apply before prescribing anything controlled. We start low, follow up closely, and adjust with you.