Panic attacks are intense, acute episodes of fear accompanied by severe physical symptoms that reach their peak within minutes. They are among the most frightening psychiatric experiences — precisely because the physical symptoms are so convincing that many people believe they are having a heart attack, losing consciousness, or dying.
Panic attacks are a clinical symptom, not a diagnosis in themselves. Their significance depends on context: whether they occur in relation to specific triggers, whether they recur unexpectedly, and how the person responds to them between episodes.
Panic disorder is diagnosed when a person experiences recurrent, unexpected panic attacks and develops persistent concern about future attacks — or significant changes in behaviour to avoid them. This avoidance — staying close to home, avoiding public transport, crowds, or situations perceived as difficult to escape — can gradually restrict a person's life substantially.
Panic disorder frequently co-occurs with agoraphobia, depression, and anxiety disorder. Panic attacks also occur within the context of PTSD and certain medical conditions — which is why accurate diagnosis is essential before treatment begins.
A panic attack involves an abrupt surge of intense fear typically reaching its peak within minutes, accompanied by:
Not every episode includes all symptoms. Some panic attacks present primarily with physical symptoms and little subjective fear — known as limited-symptom or non-fearful panic.
Because the physical symptoms of a panic attack closely resemble cardiac, respiratory, and neurological conditions, many patients first present to emergency medicine or cardiology before the psychiatric dimension is identified. This is appropriate — organic causes must be excluded. At IsraClinic, this exclusion is part of the standard diagnostic process.
The assessment for panic disorder includes a detailed clinical interview examining the nature, frequency, and context of panic episodes; a review of the patient's response between attacks — avoidance behaviour and anticipatory anxiety; assessment for co-occurring psychiatric conditions; and physical examination with laboratory and, where indicated, neurological assessment to exclude organic contributions.
The distinction between panic disorder, anxiety with panic features, and panic attacks within the context of other conditions directly determines the treatment approach. Diagnosis is confirmed collegially before any plan is finalised.
Panic disorder responds well to treatment. The combination of psychotherapy and pharmacotherapy tends to produce the most durable outcomes.
Cognitive Behavior Therapy (CBT) — specifically protocols adapted for panic disorder — is the psychotherapy with the strongest evidence base for this condition. CBT for panic addresses the catastrophic misinterpretation of physical sensations, reduces avoidance behaviour, and builds the patient's capacity to tolerate anxiety without escalation. All psychotherapy at IsraClinic is conducted directly in Russian, English, or Hebrew — without an interpreter.
Biofeedback is a complementary modality that can be effective for panic and anxiety, helping patients recognise and regulate physiological arousal responses.
Where pharmacotherapy is indicated, medication is selected individually based on the patient's full clinical profile and treatment history. Digital prescriptions are issued through the Yarpa system.
All treatment follows the Psychoergonomic Method — ensuring that each patient's programme is built around their specific presentation, not a generic panic protocol.
If panic attacks are recurring, if you are living with persistent fear of the next attack, or if you are avoiding situations because of this fear — a psychiatric assessment is appropriate. Panic disorder is highly treatable.
IsraClinic accepts patients for in-person consultation in Tel Aviv and online, in English, Russian and Hebrew. No referral is required.
Clinical Reviewer: Dr. Mark Zevin, MD — Senior Psychiatrist, IsraClinic | Last reviewed: 2026
If panic attacks are affecting your daily life or restricting what you can do, help is available. Our team is ready to assist in Russian, English, and Hebrew.