The thing nobody tells you about panic

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

Panic is not the invader you think it is; the sensation itself was never the enemy. I’ve sat with people in Chiswick, Ealing and the Richmond venue who describe the rush of heat, the thudding heart, the dizzying disorientation as if those sensations announce something catastrophic. What usually makes panic worse is the battle we start trying to outrun or suppress the very experience that is, in fact, part of being human. I’m Sanah Younis, clinical lead at The Lyceum Clinic, a BABCP accredited CBT practice in West London. In my work, it can be useful to explore the relationship a person has with frightening sensations, rather than assuming that a sensation itself proves imminent danger. Physical symptoms should not automatically be attributed to anxiety. New, severe, changing or worrying symptoms need appropriate medical assessment. Any behavioural experiments or exposure based work should be planned and agreed with a suitably qualified clinician, not taken from a blog and attempted alone. In sessions I take a warm, observational approach. We may map out early warning signs, explore beliefs about sensations and consider what support is appropriate in the person’s circumstances. The pace, focus and suitability of any therapy are individual. I do not assume that one approach, timeframe or outcome applies to everyone. If panic has been shaping your choices, it can help to talk through what is happening rather than trying to force yourself through frightening symptoms alone. A first conversation can explore whether CBT based support, medical review, practical support or another service may be the relevant next step. Panic can lead people to narrow their world gradually. A train journey, a supermarket queue, a meeting, a café or an evening alone may start to feel like situations that require escape routes or reassurance. It makes sense that a person might protect themselves after a frightening episode. The question for therapy is not whether that protection is foolish. It is whether it is still helping, what it costs, and what a safe, individual plan might look like. There is no requirement to confront a feared situation in order to prove courage. If a clinician recommends exposure based work, the rationale, pace, consent, health considerations and alternatives should be discussed carefully. If physical symptoms have not been assessed, medical advice may be more appropriate before drawing conclusions about anxiety. I offer appointments at The Lyceum Clinic and online where clinically appropriate. You can also read the panic disorder and agoraphobia guide, the panic recovery roadmap and our anxiety resources. If there is immediate danger, a risk of harm or an urgent medical or mental health need, use an appropriate emergency, crisis or healthcare service rather than relying on an online reflection.