Safety Behaviors in Panic Disorder
Why They Maintain the Fear of Panic Attacks
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People with panic disorder often develop behaviors designed to prevent or control panic attacks. These behaviors are commonly called safety behaviors.
Safety behaviors are actions someone takes to feel safer or reduce the likelihood of having a panic attack. While they may provide temporary reassurance, these behaviors often reinforce the panic disorder by reinforcing the belief that panic symptoms are dangerous.
Safety behaviors are actions someone takes to feel safer or reduce the likelihood of having a panic attack. While they may provide temporary reassurance, these behaviors often reinforce the panic disorder by reinforcing the belief that panic symptoms are dangerous.
At Anxiety & OCD Treatment Specialists, we frequently help individuals recognize and reduce safety behaviors as part of effective treatment for panic disorder.
In-person sessions are provided in Tampa and virtual sessions are available throughout Florida and New York.
What Are Safety Behaviors?
Safety behaviors are strategies people use to avoid, control, or escape panic symptoms. These behaviors are typically developed after someone has experienced one or more panic attacks.
Because panic attacks feel extremely uncomfortable, it is natural to try to prevent them from happening again. Over time, however, the brain begins to associate safety behaviors with feeling safe.
This can unintentionally strengthen the fear of panic symptoms.
Safety behaviors are easy to miss because most look like ordinary caution rather than a symptom. Checking the time before entering a meeting, sitting near an aisle seat, or texting a partner “just in case” can pass as reasonable planning, which is part of why these habits often go unaddressed for years before someone connects them to their panic symptoms.
The behaviors also tend to multiply rather than stay fixed. A single habit, like carrying water, often expands into a wider routine (checking exits, scanning for a place to sit, tracking heart rate) as the brain looks for more ways to feel prepared, which is one reason panic disorder can start small and gradually narrow someone’s daily options without a clear turning point.
Common Safety Behaviors in Panic Disorder
Individuals with panic disorder often develop specific habits or routines intended to prevent panic attacks.
Some common safety behaviors include:
Some common safety behaviors include:
- Carrying water at all times to prevent dehydration
- Avoiding heat or warm environments
- Staying close to exits in public places
- Monitoring heart rate or breathing
- Sitting down quickly when feeling anxious
- Using distractions such as scrolling on a phone
- Carrying medication “just in case”
These behaviors are not harmful in themselves, but they can reinforce the belief that panic attacks are dangerous or must be avoided.
Carrying Medication for “Just in Case”
Many individuals with panic disorder carry benzodiazepine medications such as:
- Xanax
- Klonopin
- Valium
- Ativan
Some people carry a pill in their wallet or bag as a last-resort safety measure.
Even when the medication is rarely used, simply carrying it can become a psychological safety behavior. The brain may begin to believe that panic symptoms are only manageable if the medication is available.
Over time, this can strengthen dependence on the safety behavior rather than reducing fear of panic symptoms.
Even when the medication is rarely used, simply carrying it can become a psychological safety behavior. The brain may begin to believe that panic symptoms are only manageable if the medication is available.
Over time, this can strengthen dependence on the safety behavior rather than reducing fear of panic symptoms.
Avoidance and Safety Behaviors
Safety behaviors are closely related to avoidance, another common feature of panic disorder.
For example, individuals may begin avoiding:
For example, individuals may begin avoiding:
- Exercise or activities that increase heart rate (in some cases this even includes sexual activities)
- Hot environments
- Crowded spaces
- Driving or traveling long distances
Avoidance temporarily reduces anxiety but often makes panic disorder worse over time by reinforcing the fear of bodily sensations.
Why Safety Behaviors Maintain Panic Disorder
Safety behaviors maintain panic disorder because they prevent the brain from learning an important lesson: panic symptoms are uncomfortable but not dangerous.
When someone relies on safety behaviors, they may believe:
When someone relies on safety behaviors, they may believe:
- “I avoided a panic attack because I had water with me.”
- “I stayed calm because I had my medication.”
- “I didn’t panic because I left the situation early.”
The brain never learns that panic symptoms would have passed naturally without these behaviors.
Treatment for Panic Disorder: Reducing Safety Behaviors
One of the most effective treatments for panic disorder involves gradually reducing safety behaviors.
At Anxiety & OCD Treatment Specialists, treatment often includes Exposure and Response Prevention (ERP) and interoceptive exposure therapy.
These approaches help individuals:
At Anxiety & OCD Treatment Specialists, treatment often includes Exposure and Response Prevention (ERP) and interoceptive exposure therapy.
These approaches help individuals:
- Experience physical sensations similar to panic symptoms
- Learn that these sensations are not dangerous
- Reduce reliance on safety behaviors
- Build confidence in their ability to tolerate anxiety
As fear of panic symptoms decreases, panic attacks often become less frequent and less intense to eventually no longer happening at all.
Interoceptive Exposure and Panic Symptoms
A key part of treatment involves interoceptive exposure, which intentionally creates mild versions of panic sensations such as:
- Increased heart rate
- Dizziness
- Tingling sensations
- Shortness of breath
Repeated exposure helps the brain learn that these sensations are safe and temporary.
When individuals stop fearing the sensations associated with panic, the cycle of panic disorder begins to weaken.
When individuals stop fearing the sensations associated with panic, the cycle of panic disorder begins to weaken.
When to Seek Help for Panic Disorder
It may be helpful to seek treatment if panic attacks are leading to:
- Avoidance of everyday activities
- Dependence on safety behaviors
- Constant worry about future panic attacks
- Difficulty functioning at work or in social situations
With proper treatment, individuals can learn to reduce fear of panic symptoms and regain confidence in their ability to manage anxiety.
We Are Ready To Help
Treatment is available via video conference or phone in New York, and via video, phone,
or in-person sessions in Tampa, Florida.
or in-person sessions in Tampa, Florida.
Frequently Asked Questions
About Panic Disorder Safety Behaviors
What are safety behaviors in panic disorder?
Safety behaviors are actions people take to try to prevent or control panic attacks, such as carrying water, avoiding certain environments, or staying close to exits.
Do safety behaviors make panic attacks worse?
Safety behaviors can unintentionally maintain panic disorder because they reinforce the belief that panic symptoms are dangerous.
Why do people carry medication for panic attacks?
Some individuals carry benzodiazepines for reassurance, even if they rarely use it. This can become a safety behavior.
How are safety behaviors treated?
Therapies such as Exposure and Response Prevention (ERP) and interoceptive exposure help individuals gradually reduce safety behaviors and learn that panic symptoms are not harmful.