If you’re having panic attacks, your first stop should usually be your primary care doctor, not the emergency room. A primary care visit lets you rule out physical causes, get an initial diagnosis, and receive a referral to the right specialist. That said, there are specific situations where the ER is the right call, and several other care options depending on how severe or frequent your attacks are.
When to Go to the ER
Most panic attacks, while terrifying, don’t require emergency care. ER doctors can give you medication to calm down, but the visit won’t address the underlying problem. If you have a history of anxiety and have experienced panic attacks before, experts at University of Utah Health recommend waiting 30 to 45 minutes before deciding to go. If you have calming medication at home, try that first.
There are three situations where the ER is the right choice. First, if you’re having thoughts of hurting yourself or suicide, go immediately. Second, if this is your very first episode and it came out of nowhere, get checked out. Conditions like a blood clot in the lungs can mimic a panic attack: extreme anxiety, hyperventilation, shortness of breath, and a feeling that you’re about to die. Without a prior history of panic, there’s no way to tell the difference at home. Third, if you have chest pain along with other physical symptoms like arm numbness, jaw pain, or dizziness, treat it as a potential cardiac event until proven otherwise.
For context, nearly half of people who show up to the ER with low-risk chest pain have elevated anxiety levels, and 30% to 40% of those cases turn out to be anxiety-related rather than cardiac. Getting checked is reasonable if you’re unsure, but knowing this pattern can help you feel less alarmed if it happens again after you’ve been cleared.
Start With Your Primary Care Doctor
Your primary care doctor is the best first step for recurring panic attacks. They can run the physical tests needed to rule out conditions that look like panic, including blood work to check your thyroid, an electrocardiogram to evaluate your heart, and a full physical exam. Thyroid problems and certain heart rhythm irregularities produce symptoms nearly identical to panic attacks, so getting these ruled out early matters.
Beyond the physical workup, your doctor will likely do a psychological evaluation covering your symptoms, fears, stress levels, family history, and any situations you’ve been avoiding. You may also fill out a standardized questionnaire that helps gauge the severity of your anxiety. From there, your doctor can either begin treatment directly or refer you to a mental health specialist.
Psychologist vs. Psychiatrist
These two types of specialists play different roles, and understanding the distinction helps you pick the right one. A psychologist holds an advanced degree in psychology and treats panic through structured talk therapy. The gold standard for panic disorder is cognitive behavioral therapy (CBT), which teaches you to recognize the thought patterns that fuel panic and respond to them differently. Psychologists cannot prescribe medication.
A psychiatrist is a medical doctor who specializes in mental health. They can prescribe medication, perform diagnostic evaluations, and also provide therapy. If your panic attacks are severe enough that medication seems likely, or if you want one provider handling both therapy and prescriptions, a psychiatrist is the more direct route. Many people see both: a psychologist for weekly CBT sessions and a psychiatrist for medication management.
Virtual Therapy Works Just as Well
If getting to an in-person appointment feels overwhelming, especially if your panic attacks have started limiting where you’re willing to go, telehealth is a strong option. Multiple clinical trials have found that CBT delivered over video is as effective as face-to-face CBT for panic disorder. One randomized trial measured a large treatment effect for video-based CBT that was comparable to what in-person therapy produces. A comprehensive review of online psychotherapy found no difference in outcomes, and patients reported higher satisfaction with the convenience of remote sessions.
This is particularly relevant if you’ve developed avoidance behaviors, like not wanting to drive far from home or sit in a waiting room. Video therapy removes those barriers while delivering the same evidence-based treatment.
Intensive Outpatient Programs
If your panic attacks are frequent and disruptive enough that a weekly therapy session isn’t cutting it, but you don’t need to be hospitalized, an intensive outpatient program (IOP) fills the gap. IOPs typically meet three days a week for about three hours per session, providing structured group therapy alongside individualized treatment. A step up from that, partial hospitalization programs (PHP) meet five days a week for around five hours a day.
These programs are available at behavioral health centers around the country and often accept insurance. They’re designed for people whose symptoms are too severe for standard outpatient care but who can still function at home. Your therapist or psychiatrist can help determine whether this level of care makes sense for you.
Crisis Support When You Need It Now
If you’re in distress right now and need someone to talk to, the 988 Suicide and Crisis Lifeline provides free, confidential support 24 hours a day, 7 days a week. You can call, text, or chat 988. Despite the name, it’s not only for suicidal thoughts. It serves anyone in emotional distress, including people experiencing intense panic. The service is available in Spanish and accessible for deaf and hard-of-hearing callers.
For ongoing peer support rather than crisis intervention, NAMI (the National Alliance on Mental Illness) runs peer-led support groups called NAMI Connection for people living with mental health conditions. Many groups meet virtually and are open to anyone in the country. You can find a local chapter through NAMI’s website by selecting your state.
What Insurance Typically Covers
Under federal parity protections, health insurance plans purchased through the marketplace must cover mental health services on the same terms as medical and surgical care. That means your deductible, copays, coinsurance, and visit limits for panic disorder treatment can’t be more restrictive than what the plan applies to, say, a cardiology referral. This covers therapy sessions, psychiatric visits, and intensive outpatient programs.
If you’re uninsured, community mental health centers offer sliding-scale fees, and many therapists offer reduced rates for self-pay patients. NAMI’s local affiliates can also help connect you with affordable options in your area.