Condition
Panic Disorder Treatment Long Island: End the Terror of Panic Attacks
Expert panic disorder treatment from board-certified psychiatrists. Medication, CBT, and comprehensive care to break the panic cycle at two Nassau County locations.
When Fear Strikes Without Warning
It starts suddenly. Your heart races, pounding so hard you can feel it in your throat. You can’t catch your breath. Your chest tightens, and you wonder if you’re having a heart attack. Dizziness washes over you. Your hands tingle, and you feel detached from reality. You’re convinced something terrible is happening, that you’re dying or losing your mind. Then, just as suddenly as it started, it passes, leaving you exhausted and terrified it will happen again.
If you’ve experienced this, you know the particular horror of a panic attack. And if these attacks have become recurrent, if you now live in fear of the next one, constantly scanning your body for warning signs and avoiding situations where escape might be difficult, you may have panic disorder.
At Anxiety & Depression Psychiatry, we provide specialized panic disorder treatment Long Island residents can access at our Great Neck and Mineola offices. Our board-certified psychiatrists understand panic disorder’s physiology and psychology, and we offer proven treatments that help most patients achieve significant improvement.
Understanding Panic Disorder
Panic disorder affects approximately 6 million American adults, or about 2.7% of the population. Women are twice as likely to be affected as men. While panic attacks can occur at any age, panic disorder typically develops in early adulthood.
According to NIMH data, an estimated 2.7% of U.S. adults experienced panic disorder in the past year, with prevalence higher among females (3.8%) than males (1.6%). Nearly 45% of these cases are classified as severe.
What Is a Panic Attack?
A panic attack is a sudden surge of intense fear or discomfort that reaches a peak within minutes. During an attack, you may experience:
- Racing, pounding heart or palpitations
- Sweating
- Trembling or shaking
- Shortness of breath or feeling smothered
- Feelings of choking
- Chest pain or discomfort
- Nausea or stomach distress
- Dizziness, lightheadedness, or faintness
- Chills or hot flashes
- Numbness or tingling sensations
- Feelings of unreality (derealization) or being detached from yourself (depersonalization)
- Fear of losing control or “going crazy”
- Fear of dying
The symptoms are so intense that many people having their first panic attack go to the emergency room, convinced they’re having a heart attack or other medical emergency. The physical symptoms are real, caused by the body’s fight-or-flight response activating at full force without an actual threat.
From Panic Attacks to Panic Disorder
Having a single panic attack doesn’t mean you have panic disorder. Many people experience one or two panic attacks during stressful periods and never have another. Panic disorder develops when attacks become recurrent and you develop persistent worry about having more attacks or change your behavior because of them.
Panic disorder typically involves:
Recurrent unexpected panic attacks
that occur “out of the blue” without obvious triggers. Some people also have expected attacks triggered by specific situations.
Persistent concern about future attacks
You may constantly worry about when the next attack will strike, scan your body for warning signs, or interpret normal physical sensations as the beginning of an attack.
Behavioral changes to avoid attacks
You might avoid exercise because it makes your heart race, skip caffeine because it might trigger symptoms, or avoid situations where having an attack would be embarrassing or where escape might be difficult.
The Development of Agoraphobia
Many people with panic disorder develop agoraphobia, which involves fear and avoidance of situations where escape might be difficult or help unavailable if a panic attack occurs. This might include crowded places, public transportation, enclosed spaces, open spaces, or being outside the home alone.
Agoraphobia can become severely limiting. In extreme cases, people become housebound, unable to leave their home without experiencing overwhelming anxiety. Even mild agoraphobia significantly restricts quality of life.
Panic Disorder Treatment Options on Long Island
Panic disorder is highly treatable. Research shows that approximately 70-90% of patients respond well to proper treatment. The challenge is getting care that goes beyond quick-fix approaches to address panic disorder comprehensively.
Medication Management
Several medication classes effectively treat panic disorder:
SSRIs (Selective Serotonin Reuptake Inhibitors)
are first-line medications for panic disorder. Sertraline, paroxetine, fluoxetine, and escitalopram all have strong evidence. They reduce both the frequency and intensity of panic attacks and help with anticipatory anxiety. These medications take several weeks to reach full effectiveness.
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
like venlafaxine are also effective for panic disorder and may be tried if SSRIs don’t provide adequate relief.
Benzodiazepines
like alprazolam, lorazepam, and clonazepam work quickly and can stop panic attacks in progress. They’re useful for short-term relief and as-needed use in specific situations. However, due to tolerance, dependence, and withdrawal concerns, they’re generally not recommended as sole long-term treatment.
Tricyclic Antidepressants
like imipramine and clomipramine are older medications that work well for panic disorder but have more side effects than SSRIs.
Our approach typically involves starting an SSRI for long-term control while using benzodiazepines judiciously for breakthrough symptoms during the initial weeks before the SSRI reaches full effect. We then work toward minimizing or eliminating benzodiazepine use while the SSRI provides ongoing protection.
Cognitive Behavioral Therapy (CBT)
CBT is the gold standard psychotherapy for panic disorder, with research showing it’s as effective as medication and may have longer-lasting benefits after treatment ends.
CBT for panic disorder includes:
Education about panic attacks and the fight-or-flight response. Understanding that panic symptoms, while frightening, are not dangerous helps reduce the fear that perpetuates the disorder.
Cognitive restructuring to identify and change catastrophic thinking. People with panic disorder often misinterpret physical sensations (“My heart is racing, I must be having a heart attack”) and CBT helps develop more accurate interpretations.
Interoceptive exposure involves deliberately inducing panic-like sensations in a safe environment. By hyperventilating, spinning, or exercising to create dizziness, racing heart, or breathlessness, you learn these sensations aren’t dangerous and reduce sensitivity to them.
In vivo exposure gradually confronts avoided situations. If you avoid crowded places, therapy involves gradually increasing exposure to crowds while using coping skills to manage anxiety.
Combined Treatment
Research suggests combining medication and CBT often produces better outcomes than either alone, particularly for severe panic disorder with agoraphobia. Medication can reduce symptoms enough to make CBT exercises more tolerable, while CBT provides tools that persist after medication is discontinued.
Treatment for Agoraphobia
When panic disorder includes agoraphobia, treatment must specifically address avoidance behaviors. Exposure therapy, gradually facing avoided situations while preventing escape or safety behaviors, is essential. This work can be challenging but is highly effective.
The Panic-Depression Connection
Panic disorder frequently co-occurs with depression. The chronic stress of living with panic attacks, the limitations agoraphobia creates, and shared biological factors all contribute to this overlap. When both conditions are present, treatment needs to address both.
Many SSRIs effectively treat both panic disorder and depression, making them particularly useful when conditions co-occur. Our psychiatrists evaluate for depression and other co-occurring conditions to ensure comprehensive treatment.
What to Expect at Your First Appointment
Your initial consultation involves a thorough evaluation lasting approximately 60-90 minutes. We’ll discuss your panic attacks in detail: when they started, how often they occur, what symptoms you experience, and how they’ve affected your life. We’ll also review your medical history, as certain medical conditions can cause panic-like symptoms and should be ruled out.
Many patients feel embarrassed about their panic symptoms or worry they’re overreacting to something that isn’t serious. Please know that panic disorder is a real medical condition with biological underpinnings. Your symptoms are not “all in your head,” and you’re not weak for being affected by them.
Based on your evaluation, we’ll develop a personalized treatment plan. This typically includes medication, referral for CBT, or both. We’ll explain our recommendations, discuss what to expect from treatment, and answer all your questions.
Why Choose Anxiety & Depression Psychiatry for Panic Disorder Treatment
Panic Disorder Expertise
Panic disorder requires specific expertise. Our psychiatrists understand which medications work best, how to manage the transition from benzodiazepines to long-term treatments, and when agoraphobia requires specialized attention.
Comprehensive Approach
We address panic disorder from all angles: medication to reduce attack frequency and severity, coordination with therapists for CBT, and attention to co-occurring conditions like depression or other anxiety disorders.
Individualized Care
Some patients respond beautifully to SSRIs alone. Others need combination treatment. Some have primarily unexpected attacks; others have situational triggers. Your treatment plan reflects your specific presentation and needs.
Long-Term Support
Panic disorder treatment Long Island patients receive at our practice doesn’t end when attacks stop. We provide ongoing monitoring to ensure gains are maintained, adjust treatment if needed, and support you through the gradual exposure work that addresses avoidance behaviors.
Long Island Location
Anxiety & Depression Psychiatry
300 Old Country Rd, Suite 351 Mineola, NY 11501
(646) 830-0131help@tomerlevin.comOffice Hours: Monday to Friday: 8am – 5pm
Our Mineola location is convenient to Garden City, Westbury, and central Nassau County. We’re close to NYU Winthrop Medical Center and Northwell Health’s Long Island Jewish Medical Center and Zucker Hillside Hospital.
Frequently Asked Questions
How do I know if I'm having panic attacks or a heart problem?
This is an important question that deserves medical evaluation. Panic attack symptoms can closely mimic cardiac problems, which is why many people having their first panic attack go to the emergency room. If you haven’t had a medical evaluation ruling out cardiac issues, that’s an important first step. Once medical causes are excluded, we can confidently treat panic disorder.
Will I need to take medication forever?
Not necessarily. Many patients take medication for six to twelve months, then gradually taper off while maintaining gains through CBT skills. Some patients benefit from longer-term medication, particularly if they’ve had multiple episodes. We’ll discuss the approach that makes most sense for your situation.
Are benzodiazepines dangerous?
Benzodiazepines are safe when used appropriately under medical supervision. They do carry risks of tolerance and dependence with long-term daily use, which is why we typically use them strategically while SSRIs take effect, then taper them. For some patients, occasional as-needed use for specific situations remains appropriate long-term.
What if I'm afraid to take medication because of side effects?
This is common in panic disorder patients, who are often hyperaware of bodily sensations. We start medications at low doses and increase gradually, and we discuss what to expect so you can distinguish expected adjustment effects from problems requiring attention. Most patients tolerate SSRIs well.
Can panic disorder be cured?
Many patients achieve complete remission of panic attacks and no longer meet criteria for panic disorder after treatment. Even those with some residual symptoms typically experience dramatic improvement in quality of life. The key is proper treatment that addresses both the attacks and the avoidance behaviors.
How long does treatment take?
Most patients notice significant improvement within four to eight weeks of starting medication and/or therapy. Full treatment, including addressing agoraphobic avoidance, typically takes several months. Some patients benefit from longer treatment, particularly if panic disorder is severe or chronic.
What should I do during a panic attack?
During an attack, remind yourself that while the symptoms are frightening, they’re not dangerous and will pass. Try to stay where you are rather than fleeing. Practice slow, controlled breathing. CBT teaches specific techniques for managing attacks, which we can discuss in treatment.
Break Free from the Panic Cycle
Panic disorder is one of the most treatable anxiety conditions. With proper care, most patients experience dramatic reduction in panic attacks and can return to activities they’ve been avoiding. You don’t have to continue living in fear of the next attack.
Call us at (646) 830-0131 to schedule a consultation. We’ll listen to your experience, conduct a thorough evaluation, and develop a treatment plan designed to help you reclaim your life from panic.
The attacks feel overwhelming, but they’re not unbeatable. Let us help you prove it.
Monday – Friday 8am – 5pm
Board-certified psychiatrists • Medication & CBT options • Two Long Island locations
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