Cognitive-behavioral therapy (CBT) is a type of counseling based on the theory that by changing habitual thoughts and behaviors, you can control and alleviate the symptoms of your condition.

During cognitive-behavioral therapy for panic attacks, you learn about panic disorder, its symptoms, and how to predict when a panic attack may occur. Your therapist will help you learn appropriate behaviors for responding to a panic attack and help you work through the fear of having another attack. You and your therapist work together to identify and change your patterns of thinking and behavior that may trigger or worsen panic disorder.

You may be taught exercises to help reduce the physical symptoms of the attack. For example, when you begin to experience the symptoms of a panic attack, you consciously change the way you respond. Instead of thinking, "My heart is pounding, and I feel like I can't breathe. I think I am going to die," you might instead think, "My heart is pounding, and I feel like I can't breathe, so I must be having a panic attack. Even though it is uncomfortable, I know I will be okay and the symptoms will pass." When the effects of a panic attack seem less severe, anxiety about having another attack is lessened.

Cognitive-behavioral therapy is helpful if you also have agoraphobia, which occurs when you fear and avoid public situations or places that you think may trigger a panic attack. After you are able to handle the symptoms of panic disorder, you will be exposed to controlled situations or places that have triggered panic attacks in the past. This type of treatment, known as exposure therapy, takes longer for people who have many fears, especially people with social anxiety disorder (a fear of certain social situations).