A panic attack can be one of the most frightening experiences a person goes through. It often arrives without warning: your heart pounds, your chest tightens, your breathing won't settle, and everything in you says that something is badly wrong. Many people are convinced they are having a heart attack, are about to faint, or are losing their mind. Some end up in A&E, only to be told that nothing is physically wrong, which brings relief and, at the same time, leaves the question of what just happened.

What a panic attack can feel like

In the moment, panic rarely feels like "anxiety". It feels like an emergency. It can bring:

When it passes, it often leaves you shaken, exhausted, and searching for an explanation. If you haven't already, it is sensible to see your GP to rule out a physical cause.

How the pattern builds

For many people, the attacks themselves are only part of the problem. After the first one, it is natural to start watching your body more closely, noticing every flutter or change and wondering whether another attack is on its way. That watchfulness, and the fear that comes with it, can be enough to set off the next one.

The cycle usually runs very fast. A small change in the body, such as a skipped beat, a moment of light-headedness or a tight chest, is taken as a sign of danger. The fear that follows brings more physical sensations, which seem to confirm that something really is wrong, and within seconds the panic has built.

Often it is the fear of the next panic attack, more than the attacks themselves, that starts to shape everyday life.

Gradually, life can start to arrange itself around avoiding panic. You might avoid the Tube, crowded places, exercise or coffee; sit near the door; keep water or medication close; or only go out with someone you trust. Each of these makes sense. Together, they can make your world feel smaller, and leave you feeling that panic is the one in charge.

How CBT helps with panic

CBT is the treatment of choice for panic, and it is recommended in the UK's NICE guidelines. Panic is also one of the areas where therapy most often makes a clear difference, frequently within a relatively short course of sessions.

We work systematically. First, we build a clear picture of your own panic cycle: what sets it off, what you have learned to do to get through it, and how it has affected your life. Then, step by step and at a pace we agree together, we work on the fear itself, so that you can trust your body again and stop organising your life around the next attack.

The work is tailored to you. Panic looks different from person to person, and treatment follows your situation and your goals, not a fixed script. If you would like to understand panic in more depth, I explain the CBT view of it in Panic attacks and panic disorder. Panic often sits alongside other kinds of anxiety too, which I describe on my anxiety therapy page.

Online or in person

I see people online across the UK and in person on Thursdays at The Re-mind The Body Centre in Queen's Park, North West London, close to Kilburn, Maida Vale, Kensal Green and West Hampstead. CBT for panic works well in either format, and much of the most useful practice happens out in the world between sessions anyway.

Is this the right service for you?

I work with adults (18 and over) on a private, self-pay basis. It starts with a free 10-minute phone call, so we can talk about what's been happening and whether I can help. From there, the first session is a 50-minute assessment: you'll come away with a clearer understanding of your panic and what treatment would involve, whether or not you decide to continue.