
Cognitive Behavioural Therapy (CBT) is widely recognized as a first-line, evidence-based treatment for panic attacks and panic disorder. It is effective both as a stand-alone intervention and in combination with medication, depending on individual needs.
How CBT Addresses Panic Attacks and Panic Disorder:
- Psychoeducation: CBT begins by helping individuals understand the nature of panic attacks, including the physical symptoms (such as racing heart, chest pain, dizziness, and shortness of breath) and the role of the body’s “fight or flight” response. This education helps demystify symptoms and reduce fear of the attacks themselves.
- Cognitive Restructuring: Patients learn to identify and challenge automatic, catastrophic thoughts that fuel panic (e.g., “I’m having a heart attack” or “I’m going to lose control”), replacing them with more realistic, balanced thinking. This reduces the fear and sense of helplessness that can perpetuate panic attacks.
- Behavioural Experiments and Exposure: CBT uses both interoceptive exposure (deliberately inducing panic-like sensations in a controlled setting) and in vivo exposure (gradual, real-world exposure to feared situations) to help patients confront and desensitize themselves to triggers. Over time, this reduces avoidance behaviours and the intensity of panic responses.
- Breathing Retraining and Relaxation Techniques: Techniques such as controlled breathing and progressive muscle relaxation help individuals manage physiological symptoms during an attack, promoting a sense of control and calm.
- Homework and Real-World Practice: A critical component of CBT is practicing skills outside therapy sessions. This might include tracking panic episodes, applying cognitive and relaxation strategies, and gradually facing avoided situations.
Effectiveness and Duration:
- Standard CBT treatment for panic disorder typically involves 12–15 weekly sessions, each lasting about 50–60 minutes.
- Research and clinical experience show that CBT can significantly reduce the frequency, intensity, and duration of panic attacks, as well as associated avoidance and anticipatory anxiety
CBT Techniques Commonly Used for Panic Attacks:
- Cognitive restructuring
- Breathing retraining
- Progressive muscle relaxation
- Interoceptive and in vivo exposure
- Psychoeducation about panic and anxiety
In summary, CBT is a practical, structured, and effective approach for managing and overcoming panic attacks and panic disorder, equipping individuals with lifelong skills to handle anxiety and prevent relapse.





