The panic that came from nowhere

Specialist CBT therapy for anxiety, OCD, depression and more in West London

A sudden surge of fear can feel as if it arrived from nowhere. There may be a racing heart, breathlessness, dizziness, shaking, tingling, chest discomfort, nausea, a sense of unreality, fear of losing control or a fear that something serious is happening. The experience can be frightening. It does not, on its own, establish panic disorder, explain the cause or show that a physical symptom is safe to ignore. Physical symptoms can have many causes. New, severe, changing or concerning symptoms may need medical advice or urgent care. A blog cannot assess chest pain, breathing changes, fainting, neurological symptoms, medication effects or another health concern. It should not tell someone that a medical problem is “just panic”. Sometimes an assessment identifies a pattern in which fear of a sensation, uncertainty, checking, avoidance or reassurance seeking changes what happens next. Sometimes the wider context matters: sleep, illness, grief, stress, alcohol or drug use, medication, trauma, work pressure, a difficult memory or a recent health event. The point of assessment is to understand the person’s experience carefully, rather than forcing a single explanation. CBT based therapy may be considered after assessment where clinically appropriate. It can explore the relationships between sensations, interpretations, attention, emotion, behaviour and the situations around an episode. It cannot guarantee that panic will stop, decide that a symptom is medically benign or replace medical review. Where behavioural work is clinically appropriate, it is planned collaboratively with a qualified clinician. A blog is not a self directed instruction to induce a sensation, stop a safety behaviour abruptly, avoid medical care or face a distressing situation alone. Pace, consent, safety and medical information matter. It can help to describe one episode in detail: what was happening beforehand, what was noticed first, what meaning followed, what action came next, what medical information is already available and what support was present. This does not prove a diagnosis. It can make the next question clearer. The next step may be medical review, practical support, assessment or simply more information, depending on the context. For related information, see <a href="/therapy/panic attacks/">panic support</a>, <a href="/guides/panic attacks recovery roadmap/">the panic attacks recovery roadmap</a> and <a href="/guides/how to break panic attack cycle/">the guide to the panic cycle</a>. If distress includes crisis, thoughts of self harm or an inability to keep safe, urgent appropriate help is needed.