IT HAPPENED one Saturday night amid the clatter of a Greek restaurant. My friends and I had ordered appetizers, and the waiter had poured each of us a pale glass of retsina, that pungent, resiny Greek wine.

Suddenly I began to feel as if the walls were edging in. My palms grew damp, my heart drummed, my stomach churned. I had only one shrill thought: If you don't get out of this restaurant immediately, you are going to faint, or die.

I mumbled that I didn't feel well and raced for the door. The night was clear and cold; I gulped air until my pulse quieted. Shaky, relieved, and mystified, I got into my car and drove myself home.

I'd had my first panic attack. 

I began to avoid restaurants, but then my panic started to percolate in other venues--hair salons, movie theaters, elevators, tunnels. My work, which involved teaching and public speaking, became a nightmare of nausea, sweaty palms, and heart palpitations. Ashamed, I told no one. I covered my increasingly antisocial behavior with a fistful of excuses (I was broke, I wasn't hungry, I'd seen that movie before). My world shrank to a slim corridor of safe places. Once, when I panicked at home, I wrapped myself in a quilt to smother the trembling and berated myself: Just snap out of it.

After ruling out a medical problem, my doctor prescribed Xanax. But I didn't want a pill; instead, I tried self-help, support groups, therapy, relaxation tapes, meditative breathing, and wishful thinking. Months passed. My panic attacks didn't.

It might have helped if I'd realized just how much company I had in my increasingly constricted world. Research has shown that women are twice as likely as men to suffer from panic attacks. And recently it has become clear that women's vulnerability is even greater than previously thought. The disorder, it seems, can strike older women and very young girls, as well as the women in their teens and 20s known to be most at risk. What's more, it now appears that panic attacks not only hit women more often than men, but they hit women harder.

Why are women more prone to panic? It may be due in part to fluctuating hormones that shape the way the brain processes stress, says Kamila S. White, Ph.D., who directs the behavioral-medicine program at the Center for Anxiety and Related Disorders in Boston. Estrogen in particular affects the availability of serotonin, the brain's "calming chemical."

Whatever the reason for the difference, it shows up early. A recent study found that by age 6, girls are twice as likely as boys to have an anxiety disorder. The gender difference is also evident in what happens after the problem develops, says Kimberly Yonkers, M.D., who has collaborated since 1990 on the Harvard/Brown Anxiety Research Project. "Women relapse at a threefold higher rate," she explains. "When men recover, they tend to stay well."

So that's the bad news about anxiety. But there is also good news. Panic disorder is highly treatable, responsive to both medication and cognitive-behavioral therapy. There's even a new twist on the latter treatment that promises rapid relief for those who can tolerate its intensive approach.

It was cognitive therapy that finally cured me, in 12 sessions designed to defuse my panic attacks through relaxation, reassuring self-talk, and gradual reintroduction to restaurants. My therapist gave me homework: Go to a diner alone and eat three bites of French toast. Join a friend for lunch. Have dinner at a fancy restaurant. Breathe through the cantering heartbeat, the swimmy sense of unreality. Permit the symptoms to pass.

For years, R. Reid Wilson, Ph.D., associate clinical professor of psychiatry at the University of North Carolina School of Medicine, treated his anxiety-ridden patients with this "permissive" approach. But he and a handful of other cognitive therapists now believe they have a quicker, better way, what Wilson calls the "provocative" stance of actually exacerbating panic symptoms.

Wilson may take a client into the very places she fears--a restaurant, a supermarket, for instance. When she begins to feel signs of anxiety, he encourages her to try intensifying the sensations rather than attempting to relax through them. The symptoms often start to dissipate after a few minutes, Wilson says. "We ask people to notice what they're feeling and tolerate that. What they begin to discover is, 'I can manage these feelings.'"

Others use a similar approach, but in the less threatening atmosphere of the therapist's office. If a person suffers shortness of breath during attacks, the therapist may instruct her to breathe through a straw; if dizziness is a concern, she'll be told to twirl rapidly in a chair. People with anxiety disorders overreact to their physical symptoms of distress, says White, of the Center for Anxiety and Related Disorders. "We expose them to the symptoms of panic attacks until they no longer see them as dangerous but as boring, bothersome, or annoying."

For Wilson, the new twist in treatment is primarily about attitude: The idea is to welcome panic as a kind of martial arts adversary instead of taming it with breathing techniques and relaxation mantras. "It's a mental game," he says. "You want to go toward your symptoms instead of away from them."

It's been 15 years since my first panic attack, but thinking about Wilson's method tosses me right back to that Greek restaurant--clammy palms, coiled stomach, and all. On the other hand, perhaps his confrontational approach would banish my fear of attacks forever.

I go to restaurants now, often and eagerly. I ride elevators to the 47th floor. And I breeze through the Lincoln Tunnel. But I still carry a dog-eared card that got me through some of the worst episodes of panic. "You will survive this," reads the faded print. "You always have." I keep it folded in my wallet, just in case.