I have mild panic disorder. My work requires me to travel a lot. Any ideas about how I can manage to be on an airplane for 13 hours without experiencing a single panic attack?

Panic is a form of anxiety—a very common form of anxiety. Some 2.4 million people experience one every year—and there are highly effective ways to tame anxiety. Anxiety has been called a "con game" because it tricks you into thinking about, often obsessing about, and fearing things that are not true or events that will almost never happen.

Of course, all anxiety is based on anticipating the worst. Not only do you need to know that most outcomes you fear will never come to pass, but that you can eliminate the enormous amount of time you dwell on these things. So you need not endure many hours of anticipatory worry any more than you need to endure 13 anxiety-filled hours of flying.

There are many approaches to anxiety and panic attacks, but by far the best record of success is achieved with a combination of cognitive and behavioral therapy (CBT). And therapy need not be long term. More than 80 percent of people experiencing panic attacks can be cured in eight sessions of CBT. Generally, both cognitive and behavioral techniques are used to help people overcome panic attacks. Cognitive therapy helps you identify and change the distorted thinking patterns that create anxiety, and behavioral techniques such as desensitization help you overcome anxiety through exposure to the situations you fear.

It is especially important to seek therapy as quickly as possible. It is the nature of anxiety that you begin fearing the fear and panic. That can snowball to the point where you become terrified that you could panic at any time, and so you begin to dramatically curtail what you do and where you go.

Panic attacks seem to strike out of the blue, but in fact they follow a very orderly sequence. They are a product of your own thinking. By becoming conscious of the sequence of thoughts, you are in a position to gain mastery over them.

There are many theories about the exact physiologic trigger to panic attacks, but in essence a panic attack occurs when you experience the physical sensations of anxiety—rapid heart beat, shallow breathing—and your mind makes a catastrophic misinterpretation of those sensations as dangerous. Then the anxiety escalates, leading to even more pronounced physical sensations and downright catastrophic thoughts. You may feel such extreme tightness or pressure in your chest that you are convinced you're having a heart attack. You may feel like you are suffocating from lack of air. The real problem is not the panic, but the belief that you will be in extreme danger by being on an airplane, or going out in public.

Exposure therapy also includes exposure to the feared physical sensations in a safe environment. You may be asked to literally write down new interpretations of those sensations. Whether or not you keep a log of the physical symptoms, you viscerally come to know that those sensations do not spell impending doom.