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. An individual assessment can look at what happened before, during and after an episode; how it affects daily life; 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. Progress is not always linear. A difficult episode does not mean you have failed, and early improvement does not guarantee that symptoms will disappear. You can read https://lyceumclinic.co.uk/guides/panic attacks/ and https://lyceumclinic.co.uk/therapy/panic attacks/, or arrange an initial conversation through https://lyceumclinic.co.uk/start/.