Panic attacks and panic disorder

What is panic?

Panic is a sudden rush of intense fear or discomfort that peaks within minutes, bringing physical sensations such as a racing heart, breathlessness or dizziness. A single panic attack can happen to anyone under stress. Panic disorder is the clinical term for recurring attacks alongside ongoing worry about when the next one will strike.

Panic attacks feel alarming partly because the body’s alarm system, built for genuine physical threat, fires in situations where there is no danger to run from. The sensations are real and uncomfortable, but they are not a sign that something is medically wrong in that moment. Understanding this distinction is often the starting point for working with panic, rather than against it.

Symptoms of panic

Panic shows up differently from person to person, but most people recognise a similar pattern: a fast build of fear, a cluster of physical sensations, and an urge to escape or seek safety.

Physical symptoms

Common physical symptoms include a pounding or racing heart, chest tightness, shortness of breath, sweating, trembling, nausea, dizziness or a feeling of unreality. These sensations typically peak within ten minutes and settle within half an hour, even if no action is taken.

Psychological symptoms

Alongside the physical symptoms, people often describe a fear of losing control, a fear of fainting or dying, or a sense of being detached from their surroundings. Many people also develop a fear of the fear itself, scanning their body for early signs of an attack and avoiding places or situations where one has happened before.

Types of panic

Panic can appear as a one-off response to a stressful period, or as a recurring pattern that meets the clinical threshold for a diagnosis.

Panic attacks

A panic attack is a single, time-limited episode. It can occur during a period of stress, after a physically frightening event, or seemingly out of nowhere. Most adults will experience at least one panic attack at some point, and it does not necessarily mean ongoing treatment is needed.

Panic disorder

Panic disorder involves recurrent, unexpected panic attacks together with persistent worry about having another one, and changes in behaviour to avoid that possibility. This pattern is what brings most people to therapy, since the anticipation can become as limiting as the attacks themselves.

Panic alongside other difficulties

Panic attacks often appear alongside other presentations, including health anxiety, social anxiety, agoraphobia or the aftermath of a frightening medical event. Treatment usually needs to take account of the wider picture rather than focusing on panic symptoms alone.

How therapy can help

Cognitive behavioural therapy (CBT) is the psychological treatment recommended by NICE for panic disorder. CBT works from the idea that panic is maintained by how bodily sensations get interpreted in the moment, for example reading a racing heart as a sign of a heart attack rather than a symptom of anxiety.

Therapy helps to test out these interpretations directly, often through structured exercises that bring on mild versions of the physical sensations in a safe, planned way, known as interoceptive exposure. Alongside this, sessions cover the physiology of the panic response, how avoidance keeps the fear going, and practical ways to approach rather than escape situations that have started to feel unsafe. Over a course of sessions, most people see the frequency and intensity of attacks reduce, along with the anticipatory dread between them.

Our approach

We are clinical psychologists working online with adults across Bromley and the wider south east London area, including Beckenham, Chislehurst, Shortlands, Bickley, Hayes and Petts Wood. Sessions take place by secure video call, which means no travelling either side of a working day, useful if you are already commuting from Bromley South or Bromley North into Victoria or London Bridge.

Work begins with a thorough assessment of your symptoms, their pattern and what tends to trigger or ease them, before agreeing together what a course of therapy will focus on. We draw on CBT as the main framework for panic, adapting the pace and content to what you bring to each session rather than following a fixed script.

Research comparing CBT delivered by video with CBT delivered in person for anxiety conditions, including panic disorder, generally finds similar outcomes. Working online also means sessions can fit around work and caring commitments without the need to travel into central Bromley or further into London.

What does panic therapy involve?

A typical course starts with one or two assessment sessions, building a shared understanding of how panic developed and what keeps it going for you specifically. From there, sessions usually include psychoeducation about the panic response, monitoring of attacks and triggers between sessions, and graded practice of approaching physical sensations or situations that have been avoided.

Homework between sessions is a normal part of the process, since change tends to come from practising new responses in daily life rather than from the session itself. Progress is reviewed regularly, and the plan adjusts if something is not working as expected. We will update this site as the practice develops, but for now all sessions are delivered online.

When to seek help

New chest pain, breathlessness or a racing heart can be symptoms of panic, but they can also indicate something that needs medical attention. If you are unsure, or if these symptoms are new, it is sensible to get them checked by a GP or NHS 111 before assuming they are anxiety-related.

Beyond the physical check, it is worth arranging a psychological assessment if panic attacks are frequent, if you have started avoiding everyday situations because of them, or if the fear of the next attack is shaping your daily decisions. If you are having thoughts of harming yourself, contact your GP, call NHS 111, or speak to the Samaritans on 116 123. In an emergency, call 999 or go to A&E.