What I wish I'd known about panic

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

A first episode of intense fear can be frightening. I am Sanah Younis, a BABCP accredited CBT therapist at The Lyceum Clinic in West London. Racing heart, chest tightness, dizziness and breathlessness can occur during panic like episodes, but a blog cannot establish the cause. New, severe, unusual or concerning physical symptoms should be assessed by an appropriate medical professional. After medical assessment where needed, some people find it helpful to explore whether bodily sensations, threat predictions and attempts to obtain immediate relief are interacting. The pattern differs between people. Stress, sleep, health, loss, trauma, relationships and current pressures can all be relevant. It is important not to turn one description of panic into a diagnosis. An individual assessment can look at what happened before, during and after an episode; how it affects work, travel, family life or sleep; and what you do to feel safe. If CBT is appropriate, the work is collaborative and paced. Exposure based work is planned with a qualified clinician when clinically indicated. It is not a self directed test from a blog. Breathing or grounding techniques may suit some people in some moments, but they are not a substitute for medical assessment or an individual plan. Decisions about prescribed medication belong with the clinician who prescribes it. A helpful plan may involve education, support with avoidance, consideration of other difficulties, and practical choices that fit a person’s circumstances. Progress is not always linear. A difficult episode does not mean you have failed, and early improvement does not guarantee that symptoms will disappear. The useful next step is often to understand what support is appropriate now. You can read the related /guides/panic attacks/ resource and /therapy/panic attacks/ page, or arrange an initial conversation through /start/. It may be useful to bring a brief account of what happened before, during and after an episode to an assessment. This is not a requirement to analyse yourself perfectly. It can help identify what you feared, how you tried to cope, what made the episode harder and which support is already available. Practical questions about work, travel, family responsibilities and privacy can also be part of the conversation. A thoughtful plan leaves room for uncertainty. It should respect your pace, preferences and everyday responsibilities, rather than asking you to prove that you are brave enough or well enough at once, today or tomorrow.