Panic Disorder Therapy in South Texas

Personalized therapy for adults with panic disorder and panic attacks.

The first panic attack may feel like an emergency. What often becomes disabling is everything you start doing to keep the next one from happening.

Evidence-based therapy for panic disorder, including panic attacks and the avoidance that grows around them. Online therapy for adults across Texas, including South Texas and the Rio Grande Valley.

Request a Free 15-Minute Consultation

Written and clinically reviewed by Felix Murad, M.Ed., LPC-S, LMHC, CMHC, NCC, Licensed Professional Counselor-Supervisor, with 10 years of clinical experience. Last reviewed in September 2026.

Felix Murad, LPC — therapist at Murad Counseling PLLC

When fear of panic starts changing how you live

Panic disorder rarely announces itself as a set of rules. It arrives as a series of reasonable-sounding adjustments. Some of the adjustments clients describe:

  • Avoiding highways, bridges, or long drives, or only driving in the right lane near an exit
  • Choosing the seat closest to the door in restaurants, theaters, classrooms, or church
  • Stopping exercise because a rising heart rate has started to feel dangerous
  • Avoiding stores, crowds, planes, or unfamiliar places where leaving quickly would be awkward
  • Scanning your body for the first sign of a sensation, then scanning again
  • Needing a particular person nearby, or reachable by phone, in order to go somewhere
  • Carrying medication, water, a charger, or a pulse oximeter primarily as reassurance
  • Researching symptoms repeatedly and still not feeling settled

None of these are irrational; each one made a difficult moment a bit more survivable. The issue lies in what they teach the nervous system over time.

What panic disorder actually is

A panic attack and a panic disorder are not the same thing, and the difference is where treatment does most of its work.

A panic attack is an abrupt surge of intense fear or discomfort that peaks within minutes, accompanied by physical symptoms such as a pounding heart, sweating, trembling, shortness of breath, chest sensations, dizziness, chills or heat, and numbness, as well as cognitive symptoms such as derealization, fear of losing control, or fear of dying.

Panic disorder is diagnosed when attacks recur unexpectedly and are followed by at least a month of persistent concern about further attacks or their consequences, or by a significant change in behavior to avoid them.

A panic attack on its own is a common human experience; a substantial share of adults have had at least one. Panic disorder is defined less by the attack than by what happens afterward: anticipation, monitoring, and adjustments.

The panic cycle

Most people with panic disorder are caught in a loop that is easy to describe and hard to see from the inside.

1

Sensation or trigger

A skipped heartbeat, a wave of heat, a flight of stairs, a crowded aisle, or even the memory of the last attack.

2

Catastrophic interpretation

The sensation is perceived as a signal of danger: a heart attack, fainting, suffocation, loss of control, or going crazy.

3

Fear escalates

The threat interpretation triggers more adrenaline, which produces more sensations that confirm the interpretation.

4

Escape or safety behavior

Leaving, sitting down, calling someone, checking the pulse, taking a pill, or gripping the wheel until it passes.

5

Short-term relief

Relief arrives and is credited to the escape, so the brain classifies the situation as dangerous and the behavior as necessary.

6

Increased sensitivity

The body becomes more attuned to the next sensation, and the range of places and activities that feel safe narrows.

Treatment interrupts this loop at the interpretation and the response, not by trying to prevent the sensation.

Why avoidance makes sense, and what it costs

Avoidance works remarkably well in the short term. That is precisely why it can become a problem.

Every time leaving the store or skipping the workout is followed by relief, the nervous system records a lesson: that was dangerous, and escape saved you. The lesson is wrong, but the relief is real, so the behavior is reinforced.

Over months, the map of acceptable places, activities, and distances shrinks. Work travel becomes a negotiation. Exercise stops. Errands are timed around a companion’s availability. Independence erodes without a single dramatic decision ever being made. Restoring that range is a central aim of treatment.

How treatment for panic disorder works

Effective treatment for panic disorder is structured and active. The goal is not to make panic attacks impossible; it is to change your relationship to the sensations so they no longer organize your life. Cognitive behavioral therapy with interoceptive exposure has the strongest evidence base, and elements of acceptance and commitment therapy help when the struggle against anxiety itself has become the problem. The plan is individualized, but most courses of treatment include the following components.

Assessment and formulation

We start by mapping your specific pattern: which sensations you fear most, what you believe they mean, what you do to stay safe, and what you have already given up. Standardized measures such as the Panic Disorder Severity Scale help establish a baseline.

Understanding the panic cycle

Learning how attention, catastrophic interpretation, and safety behaviors keep the alarm system sensitized. This is not reassurance; it is the working model the rest of treatment is built on.

Testing catastrophic predictions

Beliefs like “my heart will give out” or “I will lose control” are treated as predictions to examine rather than facts to argue with. Behavioral experiments provide evidence your body has not been allowed to collect.

Interoceptive exposure

Deliberately producing feared sensations in session so you can learn, from direct experience, that they are tolerable and not dangerous. This is the component most people have never been offered.

Situational exposure and dropping safety behaviors

Gradually returning to driving, stores, exercise, travel, or being alone, while removing the props that quietly maintain the fear: the water bottle, the exit seat, the escort, the phone check.

Relapse planning and measurement

Symptoms fluctuate. We track progress with repeated measures, prepare for expected setbacks, and build a plan for how you will respond to the next surge of sensations without rebuilding the avoidance.

Interoceptive exposure: meeting the sensations on purpose

Most people with panic disorder have spent years trying to keep their heart rate down, their breathing steady, and their head clear. Interoceptive exposure reverses that strategy. In session, with a clinician, you deliberately bring on the sensations you fear and stay with them long enough to learn something new.

The point is not to grit your teeth until the feeling fades. Current models of exposure emphasize expectancy violation: you make a specific prediction (“if my heart pounds for two minutes, I will pass out”), run the test, and compare the outcome to the prediction. Over repeated trials, the brain updates. The sensations may still be unpleasant, but they stop being evidence of catastrophe.

Exercises are selected to match your particular fears, introduced gradually, and adjusted for any medical considerations identified during assessment.

Examples of exercises used in session

  • Breathing through a narrow straw to produce air hunger and chest tightness
  • Brief voluntary overbreathing to produce lightheadedness and tingling
  • Spinning in a chair to produce dizziness and unsteadiness
  • Running in place or stair climbing to raise heart rate and produce sweating
  • Tensing the body or staring at a fixed point to produce derealization-like sensations
  • Drinking caffeine when caffeine has become something you avoid

Which exercises are used, how long they last, and how quickly they progress are decided collaboratively and reviewed with your physician as appropriate.

What if something is actually medically wrong?

This is a reasonable question, and treatment does not ask you to ignore it. Several medical conditions can cause panic-like episodes, including thyroid disorders, cardiac arrhythmias, asthma, low blood sugar, stimulant or caffeine effects, and withdrawal from alcohol or sedatives. A medical evaluation is part of responsible care, and if you have not had one, we will encourage you to have one.

The complication is what happens after the evaluation comes back clear. For many people, the reassurance lasts only a few days, and then doubt returns: maybe they missed something. Repeated emergency visits, cardiology follow-ups, and body checking become part of the panic cycle rather than a way out. Treatment helps you act on the medical information you already have rather than seeking certainty no test can provide.

When a medical condition and a panic disorder coexist, which is common, therapy is coordinated with your physician to ensure that exposure work is suitable for your situation. Nothing on this page constitutes medical advice.

Panic attacks are not the same as panic disorder

Panic attacks occur in many conditions. Getting the diagnosis right matters because treatment targets differ. Part of the initial assessment is determining whether panic disorder is the primary problem or whether the attacks are a feature of another condition.

  • Agoraphobia, where the fear centers on situations that would be hard to escape, with or without ongoing panic attacks
  • Social anxiety disorder, where attacks are cued by scrutiny or performance situations
  • Specific phobia, where attacks occur only around a particular object or situation
  • Posttraumatic stress disorder, where attacks are triggered by trauma reminders
  • Obsessive-compulsive disorder, where attacks follow intrusive thoughts and the response is a ritual rather than escape
  • Illness anxiety and generalized anxiety, where worry is broader than the fear of the attack itself
  • Substance or medication effects, including caffeine, stimulants, cannabis, and withdrawal states

Why work with Murad Counseling for panic disorder

Murad Counseling is a Texas-based telehealth practice focused on anxiety disorders and OCD. Treatment is provided by Felix Murad, M.Ed., LPC-S, LMHC, CMHC, NCC, a Licensed Professional Counselor-Supervisor with 10 years of clinical experience treating panic, anxiety, and obsessive-compulsive conditions.

Sessions are online, which for many people with panic disorder removes the first obstacle: driving somewhere unfamiliar to talk about the fear of driving.

  • Evidence-based methods. Cognitive behavioral therapy with interoceptive exposure, integrated with acceptance and commitment therapy where it fits the case.
  • An individualized formulation. Treatment follows your specific feared sensations, beliefs, and safety behaviors, not a fixed protocol applied to everyone.
  • Measurement-informed care. Progress is tracked with validated measures such as the Panic Disorder Severity Scale and the GAD-7, so decisions rest on data rather than impressions.
  • Anxiety and OCD specialization. Panic that overlaps with health anxiety, intrusive thoughts, or compulsive checking is recognized and treated as such.
  • Telehealth across state lines. Licensed in Texas, Washington, and New Hampshire, and registered for out-of-state telehealth in Florida.
  • A clear, time-limited plan. You will know what the treatment involves, why each step is there, and how progress is being judged.

Panic disorder therapy for South Texas, delivered via telehealth

Murad Counseling offers convenient online panic disorder therapy to adults across Texas, especially in South Texas communities where access to specialized anxiety treatment can be limited locally. Our sessions are safely conducted through secure video calls.

Clients in Washington, New Hampshire, and Florida can also be seen under the licenses and registrations listed above.

Communities we commonly serve

  • Rio Grande Valley: Harlingen, McAllen, and Brownsville
  • Corpus Christi and the Gulf Coast
  • San Antonio, El Paso
  • Austin, Dallas, and Houston

Telehealth requires that you be physically located in a state where Felix is licensed or registered at the time of each session, and that you have a private space and a stable connection. If you are unsure whether your location qualifies, ask during the consultation.

Questions people ask before starting panic disorder therapy

Short answers to common questions. Specific recommendations depend on the assessment.

Panic disorder is diagnosed when panic attacks recur unexpectedly and are followed by at least a month of persistent concern about further attacks or their consequences, or by a significant change in behavior to avoid them. Occasional panic attacks without that pattern are common and do not by themselves indicate the disorder. The distinction is made through a clinical assessment, alongside a medical evaluation to rule out physical causes. This page is educational and is not a substitute for that assessment.

No responsible clinician can guarantee that. What treatment consistently affects is your interpretation of sensations and your response to them, as well as how much your life revolves around avoiding these sensations. While many people find they have fewer and less severe attacks over time, the main aim is that if an attack occurs, it no longer dominates your day.

Interoceptive exposure involves deliberately producing feared sensations, but it is graded, collaborative, and explained in advance. You are never tricked into an exercise, and the pace is set with you. Most people find the first exercises far more manageable than expected because they are done on purpose rather than by surprise.

Controlled breathing can reduce discomfort in the moment, but when it is used to prevent a catastrophe, it becomes a safety behavior that maintains the belief that a catastrophe will occur. Treatment for panic disorder focuses on changing what the sensations mean to you, not on managing them more skillfully.

SSRIs and SNRIs are first-line medications for panic disorder, and some people benefit from combining medication with therapy. Benzodiazepines can interfere with exposure learning when used around therapy sessions. Medication decisions are made by a prescriber; we are glad to coordinate with your prescriber.

There is no fixed number. The NICE guideline for panic disorder recommends cognitive behavioral therapy in an optimal range of 7 to 14 hours in total, usually delivered as weekly sessions and completed within about four months (National Institute for Health and Care Excellence, 2011). How long it takes in practice varies with severity, agoraphobic avoidance, co-occurring conditions, and the consistency of between-session practice. Progress is monitored throughout, and the plan is adjusted with you.

Research on internet- and video-based cognitive behavioral therapy for panic disorder supports its effectiveness, and exposure work can be done at home with clinician guidance. For some people, this is an advantage: the situations you avoid are often near home, not near an office.

Private-pay sessions are $200 per 60-minute session. In-network sessions are also available through Headway for UnitedHealthcare, Anthem, and Aetna plans. Headway verifies your benefits and bills the plan, so your cost depends on your coverage. Before that, a free 15-minute phone or video consultation lets you describe what has been happening, ask questions, and decide whether this is the right fit. Details are on the fees and insurance page.

Evidence behind this approach

The treatment model described on this page is based on the cognitive model of panic and the inhibitory learning approach to exposure. Sources are listed so you can read the primary research yourself.

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
  • Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461-470. https://doi.org/10.1016/0005-7967(86)90011-2
  • Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. https://doi.org/10.1016/j.brat.2014.04.006
  • Boswell, J. F., Farchione, T. J., Sauer-Zavala, S., Murray, H. W., Fortune, M. R., & Barlow, D. H. (2013). Anxiety sensitivity and interoceptive exposure: A transdiagnostic construct and change strategy. Behavior Therapy, 44(3), 417-431. https://doi.org/10.1016/j.beth.2013.03.006
  • Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A. J., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502-514. https://doi.org/10.1002/da.22728
  • Furukawa, T. A., Watanabe, N., & Churchill, R. (2006). Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: Systematic review. British Journal of Psychiatry, 188(4), 305-312. https://doi.org/10.1192/bjp.188.4.305
  • Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of Anxiety Disorders, 55, 70-78. https://doi.org/10.1016/j.janxdis.2018.01.001
  • Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., Gorman, J. M., & Papp, L. A. (1997). Multicenter Collaborative Panic Disorder Severity Scale. American Journal of Psychiatry, 154(11), 1571-1575. https://doi.org/10.1176/ajp.154.11.1571
  • National Institute for Health and Care Excellence. (2011). Generalised anxiety disorder and panic disorder in adults: Management (Clinical guideline CG113). https://www.nice.org.uk/guidance/cg113

References are provided for education. They do not describe or predict the outcome of any individual course of treatment.

Next step

Your life does not need to keep getting smaller around panic.

If your days are being scheduled around the possibility of the next attack, structured treatment can change that pattern. A free 15-minute consultation is the first step: a short call to describe what has been happening, ask questions, and decide together whether this approach fits.

Request a Free 15-Minute Consultation
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What the first consultation involves

A short phone or video call to discuss recent events, your questions about treatment, and practical details like scheduling and fees. No obligation is involved.

Felix Murad, M.Ed., LPC-S, LMHC, CMHC, NCC. Licensed Professional Counselor-Supervisor, licensed by the Texas Behavioral Health Executive Council. Licensed in Texas, Washington, and New Hampshire; registered for out-of-state telehealth in Florida. Information on this page is educational and is not a substitute for individual assessment or medical care. If you are in crisis, call or text 988.