Those would be really good questions to talk about with your therapist.

Panic attacks are a response to anxiety. They are a behavior. If you are doing that behavior, it is called a panic attack. How can it not be real? Some people when they have panic attacks are afraid that they are having a heart attack, suffocating, dying, or going to pass out. I don't know what you are worrying about when you have a panic attack, but do you ever have panic attacks when you aren't worrying and feeling anxious? I doubt it. The heart attack, suffocation, passing out, dying, etc. aren't really going to happen, but if you are panicking, how can anyone tell you that you are not?

You might ask yourself if you need to panic to the extent that you do, or if you could stay calm if you choose to. At least the behavior you engage in. Panicking actually intensifies and creates more anxiety, so when you have a panic attack, you probably feel worse than you would if you quietly observed the emotions and maybe worked on sorting out where they are coming from.

There are physical sensations that are part of panic attacks, but those don't have to result in a panic attack. I have pretty bad anxiety, but no panic attacks. When I filled out my intake info for my pdoc, it asked about symptoms like increased heart rate, dry mouth, trembling, etc. I was extremely nervous being there for the first time. They took my blood pressure and asked if I normally had high blood pressure, or it it was because I was nervous. I don't have high blood pressure ordinarily. My mouth gets so dry that I can't talk. I've learned to cope by having gum or something to drink. People can look at me and see how nervous I am - to the point that it interferes with my career. So I answered that I had those symptoms. I had gotten to the point that I decided to try medication because I couldn't control my anxiety well enough to keep it from holding me back and also affecting people around me. Pdoc assumed that I have panic attacks, because that is what those symptoms describe. But I don't panic. I used to not even notice my anxiety symptoms, even though other people saw it. I noticed when I couldn't talk, but didn't know that was anxiety until my T identified it. I had figured that I must be allergic to people and conversations that make me nervous, or something like that.

My point is that you probably do have a higher sensitivity level, and you probably feel those physical symptoms. Maybe you always will. But you have a choice about what you do when you feel that way. You can remind yourself that it is anxiety and it will pass. Panicking doesn't make it go away. It makes it worse. And it interferes with your life.

What you feel is real, but it may be possible that your reaction to it is out of proportion. Also ask yourself what you are getting out of having panic attacks. Everything has a payoff. Is it possible that it has something to do with your relationship with your mom? It really sounds like you struggle very hard to get her to understand your emotional distress, and she doesn't validate your emotions and your experience. The result is you pushing it up a notch because you still need her to hear you, and her getting annoyed or concerned or angry and continuing to invalidate you because what you are doing makes her even more uncomfortable (parents invalidate their children because they don't know how to deal with their children's emotions, and they get anxious and panic and want to make it stop - sometimes because they want you to be happy). Would it help to get your T to help you to tell your mom about what you are feeling, and show her how to listen and validate? If your mom understood you, would you be able to have more control over extreme emotions and panic?