Panic Attack Treatment in Palm Beach
Expert psychiatric evaluation and treatment for recurrent panic attacks
What Are Panic Attacks?
A panic attack is an abrupt surge of intense fear or discomfort that peaks within minutes, accompanied by a cluster of physical and cognitive symptoms. Panic attacks are extremely common — affecting up to 11% of adults in any given year — but are one of the most distressing psychiatric experiences. Most people who have a panic attack believe they are having a heart attack, dying, or "going crazy."
Panic attacks can be expected (triggered by a specific cue or situation) or unexpected (occurring "out of the blue"). Recurrent unexpected panic attacks that cause persistent concern, behavioral change, or impairment constitute Panic Disorder. Panic attacks also occur in the context of other anxiety disorders, PTSD, and depression.
Symptoms of a Panic Attack
DSM-5 defines a panic attack by the abrupt onset of 4 or more of the following symptoms:
Treatment Approaches
Panic attacks are highly treatable. Cognitive Behavioral Therapy (CBT) — specifically interoceptive exposure, which gradually desensitizes the patient to feared bodily sensations — is the most effective long-term treatment. Patients learn to recognize that panic symptoms, while intensely uncomfortable, are not dangerous.
Pharmacologically, SSRIs and SNRIs are first-line for preventing panic attacks. Low-dose benzodiazepines (lorazepam, clonazepam) provide rapid acute relief but are reserved for specific situations due to dependence potential. Addressing the underlying anxiety disorder, PTSD, or other condition driving the panic attacks is essential for lasting improvement.
Psychiatrist & Therapist in One
Dr. Agresti is both a board-certified psychiatrist and psychotherapist — he provides medication management and CBT-based treatment in the same practice. If you're having panic attacks, you shouldn't have to coordinate between separate providers. His concierge model means direct access when symptoms escalate.
Frequently Asked Questions
Panic attacks and heart attacks share symptoms like chest pain, shortness of breath, and rapid heartbeat. Key differences: panic attacks usually peak within 10 minutes, involve tingling or derealization, and occur in younger patients. However, any new chest pain should be evaluated in an emergency room first. Once cardiac causes are ruled out, a psychiatrist can diagnose and treat panic attacks effectively.
Controlled diaphragmatic breathing, grounding techniques (naming 5 things you see, 4 you hear, etc.), and cognitive reframing can reduce panic attack intensity. For patients with recurrent attacks, a short-acting benzodiazepine prescribed for as-needed use can provide rapid relief while longer-term treatments take effect. Dr. Agresti teaches these strategies as part of integrated psychiatric and psychotherapy care.
Unexpected panic attacks often have subtle triggers — caffeine, sleep deprivation, hyperventilation patterns, or unconscious stress responses. The brain's amygdala can fire a false alarm without conscious awareness of a trigger. A thorough psychiatric evaluation helps identify contributing factors and underlying conditions like generalized anxiety disorder that may be fueling the attacks.
Yes, nocturnal panic attacks affect roughly 40-70% of people with panic disorder. They typically occur during the transition from lighter to deeper sleep stages and produce the same intense fear and physical symptoms as daytime attacks. Nocturnal attacks are particularly distressing and often lead to sleep avoidance, making proper diagnosis and treatment essential.
With proper treatment, the prognosis is excellent. CBT with interoceptive exposure produces lasting improvement in 70-90% of patients, and SSRIs significantly reduce attack frequency. Many patients achieve full remission. Dr. Agresti provides both medication management and psychotherapy, addressing panic from both the biological and psychological angles in a single treatment relationship.