Panic Therapy & Treatment
in Brooklyn, NY and online
Finding Calm in the Storm
If you’ve ever experienced a panic attack, you know how truly overwhelming it can feel—your heart racing, breath shortening, and a sudden wave of terror washing over you with no clear trigger. In these moments, you might feel completely alone, but you’re not. At Mind Body Psychiatry, we understand that panic doesn’t just affect your mind—it takes over your entire being.
The Challenge You're Facing
Panic attacks and panic disorder can make everyday activities feel impossible. Simple tasks like grocery shopping, commuting to work, or even enjoying dinner with friends can become sources of dread. Each day becomes a careful navigation around potential triggers, and the world gradually shrinks as more places and situations feel unsafe.
You deserve to reclaim your freedom and peace of mind.
A New Perspective on Panic
At Mind Body Psychiatry, we see panic differently. Rather than viewing panic attacks as something broken within you that needs fixing, we recognize them as your body’s misguided attempt to protect you. Your nervous system is doing exactly what it was designed to do—responding to perceived threats—just at the wrong time and intensity.
This perspective shift is powerful: Your body isn’t betraying you; it’s trying to keep you safe in the only way it knows how.
Our Integrative Approach to Panic
Traditional approaches often focus solely on managing symptoms through medication or standard therapy techniques. While these can be helpful tools, they rarely address the full picture of what’s happening in your body and mind during panic.
Our integrative approach is different. We combine evidence-based psychological therapies with functional medicine insights to create a comprehensive treatment plan that’s uniquely yours. We look beyond just managing symptoms to understand and address potential root causes of your panic.
What Makes Our Approach Different
- Whole-Person Assessment: We explore not just psychological factors but also physiological contributors to panic—including nutrient deficiencies, hormonal imbalances, and nervous system regulation
- Multiple Pathways to Healing: From cognitive-behavioral techniques to nutritional support, breathing retraining, and mind-body practices
- Personalized Treatment Plans: Because your panic experience is unique to you, your treatment should be too
- Empowerment Through Understanding: We help you understand exactly what’s happening in your body during panic, giving you back a sense of control
Your Path Forward
Working with our team of specialists, you’ll discover that panic doesn’t have to control your life. Many of our clients report not just reduced frequency and intensity of panic attacks, but also:
- Renewed confidence in situations they once avoided
- A deeper understanding of their body’s signals
- Effective tools to manage anxiety before it escalates
- Improved overall health and wellbeing
- Freedom to live life on their own terms again
Begin Your Journey to Calm
Taking the First Step
The first step is often the hardest, but you don’t have to take it alone. Our compassionate team is ready to walk alongside you on your journey from panic to peace.
Treatment Options for Panic
Psychological Approaches
Cognitive Behavioral Therapy (CBT)
CBT helps you identify and challenge the thought patterns that fuel panic while developing healthier responses to anxiety triggers. Research consistently shows CBT to be one of the most effective treatments for panic disorder, with benefits often lasting long after treatment ends.
Panic Control Therapy
This specialized form of CBT focuses specifically on helping you understand and manage the physical sensations of panic. You’ll learn that these sensations, while uncomfortable, aren’t dangerous—a realization that can dramatically reduce panic frequency.
Exposure Therapy
Gradually and safely facing panic-inducing situations or sensations teaches your nervous system that these experiences aren’t actually threatening. Our therapists guide you through this process at your own pace, helping you reclaim places and activities you may have been avoiding.
Integrative Medical Support
Nutritional Assessment and Support
Nutrient deficiencies like magnesium, B vitamins, and omega-3 fatty acids can contribute to anxiety and panic. Our functional medicine approach identifies and addresses these underlying factors.
Hormone Evaluation
Thyroid imbalances, adrenal issues, and sex hormone fluctuations can all trigger or worsen panic symptoms. Many clients find significant relief when these underlying hormonal factors are identified and addressed.
Gut-Brain Connection
Emerging research shows strong connections between gut health and mental health. Our team explores how optimizing your digestive health may improve your mood and reduce panic vulnerability.
Mind-Body Practices
Breath Retraining
Many people with panic disorder have developed subtle breathing pattern disorders that can trigger or worsen attacks. Learning to restore natural, balanced breathing can provide immediate relief and long-term resilience.
Biofeedback and Heart Rate Variability Training
These science-backed techniques help you develop conscious control over your body’s stress response systems, giving you powerful tools to prevent and manage panic.
Mindfulness-Based Approaches
Learning to observe your thoughts and sensations without judgment can transform your relationship with anxiety. Our mindfulness training helps you develop present-moment awareness that creates space between you and your panic symptoms.
The Right Combination for You
No single approach works for everyone. Our team works with you to find the right combination of treatments that addresses your unique needs and experience of panic.
Join 500+ people taking charge of their health.
“For years, I thought I was just ‘broken’ and would have to live with panic attacks forever. Working with Mind Body Psychiatry changed everything. They found that I had significant magnesium deficiency and hormonal imbalances that were contributing to my anxiety. With the right supplements, nutritional changes, and CBT skills, I went from having panic attacks weekly to not having had one in over a year. I have my life back.”
“After my first major panic attack, I started avoiding so many situations—flying, elevators, crowded stores—anything that felt ‘trapped.’ My world kept getting smaller. The team at Mind Body Psychiatry helped me understand what was happening in my body during panic and gave me tools to work through it instead of running from it. I’m now doing things I never thought I’d be able to do again.”
Explore Our Panic Treatment Resources
Deeper Understanding for Your Journey
This section provides more in-depth information about panic disorder and treatment options. Each expandable section offers valuable insights to support your recovery journey.
Understanding Panic: Beyond the Basics
What Really Happens During a Panic Attack?
A panic attack is a complex cascade of physiological reactions triggered by your body’s fight-or-flight response. Here’s what’s actually happening:
- Threat Detection: Your amygdala (the brain’s alarm system) perceives a threat—whether real or imagined
- Hormone Release: Your body releases adrenaline and cortisol, preparing you to fight or flee
- System Activation:
- Increased heart rate and blood pressure to deliver oxygen to muscles
- Rapid breathing to take in more oxygen
- Blood diverted from digestion to muscles
- Pupils dilate to enhance vision
- Sweat production increases to cool the body
- Feedback Loop: These physical sensations themselves can become frightening, creating a cycle where fear of symptoms intensifies the symptoms
Specific nutrients play crucial roles in sleep regulation:
The Respiratory Connection in Panic
Many people with panic disorder have a respiratory subtype (RS) of panic disorder. This means the panic symptoms are directly related to the balance of oxygen and carbon dioxide in your blood.
When you’re anxious, you may unconsciously breathe more quickly and shallowly (hyperventilation). This actually decreases carbon dioxide levels in your blood, which can trigger:
- Lightheadedness
- Tingling in extremities
- Chest tightness
- Heart palpitations
- Shortness of breath
These symptoms can then trigger panic attacks in vulnerable individuals. Interestingly, people with this subtype often respond exceptionally well to breathing retraining techniques.
The Mind-Body Connection in Panic
Panic disorder powerfully illustrates the inseparable connection between mind and body. Thoughts influence physical sensations, and physical sensations influence thoughts in a continuous feedback loop.
For example:
- A racing thought like “I can’t breathe” can cause you to hyperventilate
- The sensation of hyperventilation can then reinforce the thought “Something is wrong with me”
- This thought increases anxiety, which intensifies physical symptoms
- The cycle continues, escalating into panic
Treatment approaches that address both the psychological and physical aspects of panic tend to be most effective for breaking this cycle.
Root Causes of Panic: A Functional Medicine Perspective
Nutrient Deficiencies and Panic
Several nutrient deficiencies have been associated with increased vulnerability to panic and anxiety:
- Magnesium: Often called “nature’s relaxant,” magnesium deficiency can cause increased muscle tension, anxiousness, and even panic attacks. Magnesium regulates the excitatory threshold of cells in your nervous system.
- B Vitamins: Particularly B6, B12, and folate play crucial roles in producing neurotransmitters that regulate mood. Deficiencies can contribute to anxiety and panic symptoms.
- Omega-3 Fatty Acids: These essential fats help reduce inflammation in the brain and support healthy neuron function. Low levels have been linked to increased anxiety and mood disorders.
- Zinc: This mineral modulates the body’s stress response and helps regulate GABA, a calming neurotransmitter in the brain
- Vitamin D: Beyond bone health, vitamin D functions as a neurosteroid, influencing brain development and function. Low levels correlate with increased anxiety.
- Iron: Iron deficiency can lead to reduced oxygen transport, potentially triggering respiratory symptoms that can cascade into panic, especially in those with respiratory-subtype panic disorder.
- Antioxidants (Vitamins C, E, Selenium): These nutrients help manage oxidative stress, which has been linked to anxiety disorders, including panic.
At Mind Body Institute for Integrative Health, we can test for these deficiencies and develop a targeted nutrition plan to address them as part of your comprehensive treatment.
Hormonal Imbalances and Panic
Various hormonal imbalances can either mimic panic symptoms or make you more vulnerable to panic attacks:
- Thyroid Dysfunction: Hyperthyroidism can cause symptoms nearly identical to panic attacks—racing heart, anxiety, trembling, and heat intolerance. Even subtle thyroid imbalances can contribute to anxiety.
- Adrenal Issues: Your adrenal glands produce stress hormones like cortisol. Dysregulation in this system can heighten your stress response, making panic more likely.
- Sex Hormone Fluctuations: Changes in estrogen and progesterone can influence anxiety levels. This helps explain why panic disorder affects women at twice the rate of men, and why symptoms often fluctuate with menstrual cycles.
- Blood Sugar Regulation: Rapid drops in blood sugar can trigger adrenaline release as a protective mechanism, but this can sometimes cascade into panic symptoms.
Our comprehensive hormone assessment can identify these potential contributors to your panic symptoms.
Allergies, Histamine, and Panic
The connection between allergic reactions and panic symptoms is often overlooked but can be significant:
- During allergic reactions, your body releases histamine and adrenaline
- Histamine can affect your breathing pattern and ventilatory threshold
- Adrenaline release can trigger anxiety and panic-like symptoms
- Some allergic reactions, especially milder ones, may be misinterpreted as panic
For some individuals, managing underlying allergies and histamine sensitivity can significantly reduce panic symptoms. This is particularly relevant if you notice your panic symptoms tend to be worse during certain seasons or after consuming specific foods.
Environmental Factors and Toxicity
Environmental exposures can impact mental health in ways we’re only beginning to understand:
- Heavy Metals: Mercury toxicity, for example, has been linked with increased anxiety and panic disorder
- Environmental Chemicals: Some pesticides, plastics, and industrial chemicals can disrupt neurotransmitter function and increase anxiety vulnerability
- Mold Exposure: Certain molds produce mycotoxins that can affect brain function and trigger anxiety symptoms
For some individuals, identifying and addressing these environmental factors can be an important piece of the recovery puzzle.
Special Considerations
Agoraphobia and Panic: Breaking the Cycle
Agoraphobia—fear of places or situations that might cause panic—often develops as a complication of panic disorder. When panic attacks happen repeatedly, you may begin avoiding places where they’ve occurred or where help might not be available.
Breaking this cycle requires specialized approaches:
- Graded Exposure: Working with a therapist to gradually and systematically face feared situations, starting with less challenging ones and progressing as comfort increases.
- Safety Signals: Learning to recognize internal resources and external supports that help you feel safer when facing challenging situations.
- Anticipatory Anxiety Management: Developing strategies to manage the anxiety that comes before entering feared situations, which is often worse than the actual experience.
- Building Independence: Gradually reducing reliance on “safety people” or safety behaviors that maintain avoidance in the long term.
With proper support, even severe agoraphobia can be overcome. Many clients who once couldn’t leave their homes eventually return to full, active lives.
Panic and Sleep: Restoring Restful Nights
Panic and sleep problems often form a vicious cycle—anxiety disrupts sleep, and poor sleep increases vulnerability to anxiety and panic. Breaking this cycle involves:
- Sleep Hygiene: Establishing regular sleep/wake times, creating a restful environment, and developing a calming bedtime routine.
- Worry Time: Scheduling 15-20 minutes earlier in the day to address worries, rather than ruminating at bedtime.
- Nighttime Panic Management: Specific strategies for calming your nervous system if you wake with panic symptoms during the night.
- Stimulus Control: Strengthening the association between your bed and sleep by using it only for sleep and intimacy.
- Managing Sleep-Related Anxiety: Addressing specific fears about sleep itself, such as fear of having panic attacks during sleep or fear of not getting enough sleep.
Improving sleep quality can significantly reduce daytime anxiety and panic vulnerability.
When Medication Might Help
While our approach emphasizes comprehensive, root-cause treatment, medication can be a helpful tool for some individuals. Options include:
- Selective Serotonin Reuptake Inhibitors (SSRIs): These antidepressants are often the first-line medication treatment for panic disorder. They typically take several weeks to reach full effectiveness.
- Benzodiazepines: These medications work quickly to reduce anxiety but are typically used short-term due to potential for dependence and tolerance.
- Other Options: Several other medication classes, including SNRIs, certain anticonvulsants, and beta-blockers, may help specific panic symptoms.
If you’re considering medication, we can coordinate with psychiatric providers to ensure an integrated approach that incorporates it as one component of your comprehensive treatment plan.
Supporting a Loved One with Panic Disorder
If someone you care about struggles with panic, here’s how you can help:
- Get Educated: Understanding what panic is (and isn’t) helps you respond supportively.
- Validate Their Experience: “I can see this is really hard” is more helpful than “There’s nothing to be afraid of.”
- Encourage Treatment: Gently support them in seeking professional help when they’re ready.
- Avoid Enabling Avoidance: While forcing someone into feared situations isn’t helpful, neither is helping them avoid everything that causes anxiety.
- Practice Patience: Recovery isn’t linear—expect good days and challenging days.
- Take Care of Yourself: Supporting someone with panic can be draining; maintain your own support system and boundaries.
Remember that with proper treatment, panic disorder has an excellent prognosis. Your supportive presence can make a significant difference in your loved one’s recovery journey.
Frequently Asked Questions
What's the difference between an anxiety attack and a panic attack?
While many use these terms interchangeably, they describe different experiences. Anxiety attacks typically build gradually in response to a specific stressor, while panic attacks often come on suddenly, sometimes without an obvious trigger. Panic attacks also tend to be more intense, featuring severe physical symptoms like chest pain, shortness of breath, and a sense of detachment from reality. A true panic attack usually peaks within 10 minutes and includes at least four of the symptoms listed in diagnostic guidelines.
Are panic attacks dangerous? Can you die from them?
Despite how frightening they feel, panic attacks are not physically dangerous. Your body is experiencing a surge of adrenaline—the same stress hormone released during exercise or excitement. While your heart beats faster and your breathing changes, these changes are well within the safe physiological limits of your body. No one has ever died from a panic attack itself, though the fear that you might can make the experience even more terrifying. This fear is actually one of the factors that can perpetuate panic disorder.
Why do I feel like I'm dying or going crazy during a panic attack?
These frightening thoughts occur because panic attacks activate your body's emergency system, which is designed to respond to life-threatening dangers. Your brain interprets the intense physical sensations as evidence of serious danger, leading to thoughts like "I'm having a heart attack" or "I'm losing my mind." These catastrophic thoughts are a normal part of panic but don't reflect reality. With treatment, you can learn to recognize these thoughts as symptoms rather than facts.
Can panic attacks happen during sleep?
Yes, some people experience nocturnal panic attacks that wake them from sleep. These can be especially frightening because they occur without any obvious trigger. They typically happen during transitions between sleep stages, particularly from stage 2 to stage 3 sleep, not during dreaming (REM) sleep. If you experience regular nocturnal panic attacks, mention this to your provider, as it may influence your treatment approach.
Will I need to take medication for panic forever?
Not necessarily. While some people benefit from longer-term medication, many successfully taper off medication after their symptoms stabilize. The decision depends on many factors, including the severity of your symptoms, your response to other treatments, and whether you have recurring episodes. If medication is part of your treatment plan, we'll regularly reassess its continued necessity and effectiveness. Many clients successfully transition from medication to psychological and lifestyle management strategies over time.
Does everyone with panic disorder develop agoraphobia?
No. While about 30-50% of people with panic disorder develop some agoraphobic avoidance, many do not. Early treatment of panic symptoms can help prevent the development of agoraphobia. Even for those who do develop agoraphobic avoidance, effective treatment can help you reclaim your ability to go anywhere comfortably. Remember that agoraphobia develops as a logical response to frightening panic experiences—it's your mind's attempt to keep you safe, even though it ultimately limits your life.
Can children and teenagers get panic disorder?
Yes, panic disorder can affect children and adolescents, though it's more commonly diagnosed in late adolescence and early adulthood. Children may describe their symptoms differently or have trouble articulating what they're experiencing. They might complain of stomachaches, dizziness, or feeling "weird" rather than identifying these as anxiety symptoms. The good news is that young people often respond very well to treatment, particularly to cognitive-behavioral approaches adapted for their age group.
What should I do if I'm having a panic attack right now?
First, remind yourself that although panic feels terrible, it is not dangerous
and will pass. Then:
- Focus on your breathing: Take slow, deep breaths through your nose, filling your lower lungs, and exhale slowly through slightly pursed lips.
- Ground yourself: Notice and name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
- Challenge catastrophic thoughts: Remind yourself "This is anxiety, not danger" or "This feeling will pass."
- Accept the feelings: Fighting against panic often makes it worse. Try to ride the wave, knowing it will crest and then subside.
- Use cold sensation: If possible, splash cold water on your face or hold an ice cube. This can help activate your parasympathetic nervous system.
Remember, each panic attack does end, typically within 20-30 minutes, even if you do nothing at all.
How do I help someone else who's having a panic attack?
If someone you care about is experiencing a panic attack:
- Stay calm: Your calmness can be contagious and reassuring.
- Speak in a soothing voice: Use short, simple sentences and a gentle tone.
- Validate their experience: Say things like "I can see this is really scary, but you're going to be okay."
- Avoid minimizing: Don't say things like "Just calm down" or "There's nothing to be afraid of."
- Offer to help them slow their breathing: "Let's breathe together" can be more helpful than telling them to breathe.
- Ask what they need: Some people want space, while others want company or physical touch.
- Remind them it will pass: "This feeling won't last forever; it will ease soon."
After the panic attack subsides, encourage them to seek professional help if these attacks are recurring or causing significant distress.
Will my insurance cover panic treatment?
Most health insurance plans provide coverage for the treatment of panic disorder, as it's a recognized mental health condition. Coverage typically includes therapy sessions with licensed mental health providers and necessary medications. At Mind Body Psychiatry, we can verify your benefits before your first appointment and discuss any potential out-of-pocket costs. We also offer options for those without insurance coverage or with high deductibles.
Can I recover completely from panic disorder?
Absolutely! Panic disorder has one of the highest treatment success rates among anxiety disorders. With proper treatment, many people experience complete remission of panic attacks and return to all activities they previously avoided. Even those who occasionally experience mild symptoms usually develop the skills to manage them effectively without significant distress or life disruption. Recovery doesn't always mean never feeling anxious again—it means the anxiety no longer controls your life.
How is Mind Body Psychiatry's approach different from other practices?
Our approach differs in several key ways:
- Root Cause Focus: Rather than just managing symptoms, we investigate potential underlying factors like nutrient deficiencies, hormonal imbalances, and nervous system dysregulation.
- Integrated Team Approach: Our team includes mental health professionals, functional medicine practitioners, and mind-body specialists who collaborate on your care.
- Personalized Treatment Plans: We recognize that panic has many potential causes and contributors, so we tailor treatment to your specific situation rather than using a one-size-fits-all approach.
- Empowerment Through Education: We help you understand exactly what's happening in your body during panic, transforming frightening mysteries into manageable experiences.
- Comprehensive Toolkit: We draw from both traditional and complementary approaches, giving you multiple strategies to overcome panic.
Do you prescribe medication for panic?
While our approach emphasizes comprehensive, root-cause treatment, we recognize that medication can be a helpful tool for many people with panic disorder. Our psychiatric providers can prescribe medication when appropriate as part of an integrated treatment plan. We take a thoughtful approach to medication, carefully weighing potential benefits against possible side effects, and regularly reassessing whether continued medication is necessary as you progress in treatment.
What should I expect at my first appointment?
Your first appointment will focus on understanding your unique experience with panic and anxiety. We'll ask about:
- Your specific symptoms and how they affect your life
- When you first started experiencing panic attacks
- Triggers you've noticed
- Treatments you've tried before
- Your overall health history
- Current medications and supplements
- Diet, sleep, and lifestyle factors that might impact your anxiety
This appointment is also your opportunity to ask questions and share your goals for treatment. Together, we'll develop an initial treatment plan tailored to your needs. You won't be pressured to commit to any particular approach—our goal is to provide options and support your decisions about your care.