A panic attack can feel like a heart attack, like you are losing control, or like something is terribly wrong — and then it passes, leaving you shaken and afraid it will happen again. As frightening as panic feels, it is not dangerous, and panic disorder is one of the most treatable conditions in mental health. You are welcome here.

What panic disorder is

A panic attack is a sudden surge of intense fear that peaks within minutes, with strong physical symptoms. Panic disorder is when these attacks keep happening unexpectedly and you start to worry about the next one or change your life to avoid it. It affects about 2.7% of U.S. adults in a given year and is about twice as common in women (National Institute of Mental Health, n.d.).

Signs and symptoms

During a panic attack, people often feel several of these at once:

• Racing or pounding heart, chest tightness.
• Shortness of breath or a choking feeling.
• Dizziness, sweating, trembling, or tingling.
• A sense of unreality, or fear of dying or “losing control.”

Between attacks, many people live with anticipatory anxiety — dread of the next attack — and begin avoiding places or situations where one might happen. That avoidance is treatable too.

How it is understood and evaluated

A careful history is how we understand your experience and, when appropriate, make sure nothing medical (such as a thyroid or heart issue) is driving the symptoms. If you are having chest pain or your very first attack, it is reasonable to be checked medically to be safe. You can share at your own pace.

Brief screening (96127)

To understand your symptoms and track your progress, we use brief, validated questionnaires — administered, auto-scored, and documented on the CNS Vital Signs platform and billed under code 96127 (brief emotional/behavioral assessment) — including the GAD-7 and the DASS (Spitzer et al., 2006; CNS Vital Signs, n.d.). Each takes only a few minutes.

How it is treated — and how we approach it at OhanaPsych

Panic disorder responds very well to treatment. National guidelines recommend cognitive behavioral therapy (CBT) — including exposure techniques that gently retrain your body’s alarm system — and medication as first-line options, alone or together (American Psychiatric Association, 2009; Melaragno, 2021). The medications with the best evidence are SSRIs and SNRIs; fluoxetine, sertraline, and paroxetine are FDA-approved for panic disorder, and venlafaxine is also effective.

Fast-acting sedatives (benzodiazepines) can calm a crisis, but they carry real risks with regular use, so we use them sparingly and thoughtfully, if at all, and focus on treatments that build lasting relief. We hold this work with aloha, with the goal of restoring lōkahi (balance and harmony) so panic loses its grip and your world opens back up. We coordinate care with your therapist and primary-care team.

Getting care by telehealth

Most of our care is delivered by secure video, so you can begin from a private, comfortable place of your own. Some parts of care — such as certain controlled medications — still follow the federal Ryan Haight Act and DEA rules and may call for an in-person step; we will tell you clearly if that applies to you.

Lasting access by telehealth

As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. For our patients, that means dependable, lasting telehealth access to the care you need.

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

When to reach out

You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.

If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.

References

American Psychiatric Association. (2009). Practice guideline for the treatment of patients with panic disorder (2nd ed.). American Psychiatric Association. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf

CNS Vital Signs. (n.d.). CNS Vital Signs computerized rating instruments. https://www.cnsvs.com/WhitePapers/CNSVS-RatingInstruments.pdf

Melaragno, A. J. (2021). Pharmacotherapy for anxiety disorders: From first-line options to treatment resistance. Focus, 19(2), 145–160. https://doi.org/10.1176/appi.focus.20200048

National Institute of Mental Health. (n.d.). Panic disorder. https://www.nimh.nih.gov/health/statistics/panic-disorder

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092